This document provides an overview of an organization that provides integrated health and social care services in Cumbria and Lancashire. It discusses the organization's strategy, purpose, and model of service delivery. The model focuses on four main program areas - mental health and emotional wellbeing, women at risk, learning and development, and community outreach. It provides statistics on clients served and interventions provided in 2016-2017. It then discusses several specific mental health services and programs in more depth, including IAPT services, support for victims of crime, couples therapy, and perinatal mental health services. It reflects on service developments, outcomes tracking, and looking toward the future.

1. Sharing What We Know –
Updates and Insights

2. Our Strategy
Providing high quality integrated Health and Social Care within Cumbria and Lancashire
Innovative WomenCentred Professional
Encouraging Open and
inclusive
Enabling Supportive
Non
Judgemental
Our Purpose
The way we
do things…
We are…
Women and their families in the communities we serve are able to achieve their potential to develop
their skills and live safe, healthy and prosperous lives

3. Our Model
Four main programme areas:
• Mental Health and Emotional Wellbeing
• Women at Risk Employment, Advice and Guidance
• Learning and Development
• Delivered through:
• An integrated one stop shop female only setting
• Expansive network of community settings
• Integrated approach
• Lancashire and Cumbria
• Service User Engagement

4. Our Model
• Connecting with communities
• Third Sector leadership
• Working in partnership
• Harnessing the power of digital

5. Supporting Wider Community Wellbeing

6. Our Model in Action
16/17:
• 3979 individuals accessed support
• 4698 full individual interventions were accessed (around 20% of clients
access multiple services)
• 10% from BME communities
• 10% male
• 2238 accessed therapeutic services
• 92% - recommend the service to a friend

7. Mental Health
Services

8. Overview
Mental Health Work Stream :
 IAPT service in East Lancashire and Blackburn with Darwen
 Easily assessable community based service
New Therapeutic Commissions:
 Long term physical health conditions
 Victims of crime
 Couples therapy for parents
 Perinatal
 Neonatal

9. IAPT LTC ( Long Term Conditions)Therapy
The IAPT for long term Physical health conditions is a
new project supporting individual’s with a physical
health condition or medically unexplained symptom
such as;
 COPD
 Diabetes
 Fibromyalgia
The LTC therapy is delivered
 1-1 by CBT and PWP therapists at step 2 or step 3
 In a group setting at step 2

10. National Evidence
 5 Year Forward view on Mental Health’ - government’s extended
commitment to achieving parity of esteem for mental and physical health.
 By 2020/21 an additional 600,00 people with depression or an anxiety
disorder, will be able to access IAPT services
 Presence of LTCs or MUS’s markedly increases the risk of a comorbid
mental health problem and vice versa
 World Health Surveys: 2 or more Long term conditions 7X more likely to
have depression than people without LCT.

11. Supporting Victims of Crime
 Funded by Victim’s Services
 Lancashire wide
 Women, men and children who have been victims of crime
 Referrals via Victim Support
 Delivered in local communities
 Range of therapeutic provision

12. Couples Therapy for Parents
 Funded by Blackburn with Darwen Council
 Therapy for co-parents / couples with 4 + Adverse Childhood
Experiences
 Delivered by a Couple Therapist in local nurseries

13. Adverse Childhood Experience (ACE)
 Individuals who have experienced 4 or more ACE’s can often
experience mental health issues, as well as parenting or relationship
issues in adult life
 4 x more likely to develop Diabetes
 3x more likely to develop Heart disease
 3x more likely to develop respiratory disease
 Parents seen on this project with a LTC will be offered LTC Therapy

14. Meeting Client Need
 Since starting these additional projects delivery
at outreach locations has grown exponentially
improving accessibility and inclusivity.
 Feed back from clients
“It’s good to talk to people feeling the same way”
“ I Feel much better for just speaking to you”

15. Tracking Engagement and Recovery
 Statistics –collated and compared
 LWC recovery rates are above the national average at 68%, and we
continue to see improvement in these
 Ongoing review of client demographics to enable proactive engagement of
excluded groups, including BME communities and those 65+
 Outcome stars

16. Service Developments
Increased therapy provision across Lancashire
Larger range of modalities with greater client choice
Therapies including EMDR, pre trial and specialist children’s
therapy

17. Looking Forward
We continue to consider and incorporate new ways of working:
 Reflecting on how we keep up with a fast paced environment and
new ways of communicating
 Growing online community - how do we best utilise this?
 Enhance work completed in session
 Additional means of emotional support for clients between sessions
and for clients to access independently when sessions have
completed
 Benefit a wider variety of people

18. Our Call to Action
• Help patients/clients recognise mental health problems
• Help patients/clients understand links between LTC and mental
health problems
• Support referral into LWC
• Link in with our integrated approach

19. WorkFit Womenfunded by European Social Fund

20. A Needs Informed Approach
• Economic activity rates appear to show women in
Lancashire particularly disadvantaged within the labour
market.
• Women in Lancashire have higher economic inactivity rates
than national averages
• Multiple factors in most deprived areas exclude large
number of residents from the labour market – benefit
dependency, low skills, low incomes, health and housing
issues.
• Widely accepted that work is generally good for mental
health.
• Differentiated and customised gendered approach proven
to be highly effective route to engagement with women
who are isolated, marginalised, lacking confidence and
self-esteem
LWC have over 30 yrs experience working
with women with multiple and complex
needs
Lancashire ESIF Strategy
IAPT – Improving Access to Psychological
Therapies
Lancashire Skills & Employment Strategic
Framework (2016-2021)

21. How does the model work to meet need?
Key Coach provides 1-1 Assessment,
Advice, Guidance and Support
Holistic package of support –
Therapeutic, Financial, Childcare,
Personal development
6 week Workfit Group Programme
Supported Volunteer Placement
Wider support- Work Clubs, Digital
Inclusion , Mentors
Improved psychological & physical
wellbeing
Develop social support networks &
community peer support
Increased skills & enhanced
prospects through work experience
Improved knowledge – make
informed decisions about future
employment options
Increased confidence to gain skills,
qualifications & job opportunities

22. Early Findings
Three months into project delivery
• May 2017 – April 2020 624 women (137 Employment, 108 Education/Training, 65 Inactive to employment or job
search)
• Surprising success with support from businesses regards Work Expereince Placements
• Key Coach embedded within holistic offer enhances tailored approach to suit individual need.
• Networking / Marketing met with enthusiasm and generating referrals
• Natural progression to sustained mental health and wellbeing

23. Partnership
Lancashire ESF Projects – Lead Bodies
Moving on
Invest in Youth (IIY)
Access to Employment
Access to Apprenticeships
Age of Opportunity
Journey 2 Work
Changing Futures
More Positive Together
Strengthening Communities –
Volunteering in Lancashire
My Place
Workfit Women
Skills Support – Redundancy
Skills Support - Workforce
…….& many
partner
agencies

24. Partnership & Stakeholder Support
Priority 1.4
Invest in Youth
Changing Lives
Age Of Opportunity
Active Inclusion Projects
Priority 2.1
Employee Skills
Support
Access to employment for Jobseekers
and Inactive people (1.1) – some
barriers but relatively close to labour
market
Enhancing Equal
Access to Lifelong
Learning (2.1)
Active Inclusion
(1.4) to help those
more distant from
the labour market
Sustainable
integration of Young
people(1.2) –
particularly NEET or
at risk of NEET

25. Partnership & Stakeholder Support
• Success relies on collaborative approach - the right provision for each
individual & ‘No Wrong Door’
• Cross sector support – Work Experience Placements/skill development
• How to sustain projects post Brexit?
o UK Shared Prosperity Fund?
o EU money potential to fund through to 2022?
o Positioning Employment Support as an integral part of IAPT

26. Exploring What Underpins our Approach – Supporting Women
with Multiple and Complex Needs
• Underpinning our Approach- Sarah Swindley, CEO
• Developing a Female Offender Whole Systems Approach – Vickie
Barritt, FOWSA Strategic Lead

27. Talking about gender
• Underpinning our approach is a belief
that gender matters
• Impacts on us all – gender pay gap is
real and local
• Complex and tricky area, can mean put
in ‘too hard to do’ box
• Nervousness re GED

28. Supporting Women with Multiple and Complex Needs
• 3 gendered factors
compounded for
women and girls at
risk
Social
Inequalities
Violence,
abuse and
trauma
Gender
Expectations

29. Supporting Women with Multiple and Complex Needs
• Agenda Research -
• One in 20 women have experienced extensive physical and sexual violence as both a child and an adult: that’s
1.2million women in England alone.
• These women face very high rates of problems like mental ill-health, addiction, homelessness, and poverty.
• More than half have a common mental health condition
• More than half have a disability
• Nearly half are in the lowest income bracket
• One in three have attempted suicide
• One in five have been homeless
• One in three have an alcohol problem

30. National Picture
• Approximately 11,000 women in hostels
• Nearly 7000 women sent to prison each year
• 80,000 women involved in sex working
• Much vulnerability not quantified
• Changing picture and hidden need

31. What does our experience tell us?
• Poor outcomes are in large part predictable, but not always
preventable
• Systems are not designed holistically, although this is slowly shifting
• Women are constantly and consistently below the radar, don’t meet
thresholds and low numbers can mean not a priority.

32. Our influence and reach- how can we ‘nudge’
Nationally:
• HMPPS Women’s Strategy
• Working with Agenda
• Working with the Kings Fund
Regionally:
• Female Offenders Whole Systems Approach
• Today!
• Working with others to consider gender

33. Our Impact
• GSK Impact Awards Video -
• https://vimeo.com/66159646

34. Female Offender
Whole System Approach

35. Female Offender Whole System Approach
• Successful in securing funding from the MOJ
• We were one of six successful bidders nationally
• Funding aims to provide a more joined-up and tailored support for local
women at risk of crime and in the justice system
• Bringing together local agencies and services to provide wraparound care
and reduce offending

36. Project Overview
Providing the strategic support needed to further develop and
embed a whole systems approach for females in Lancashire and
Cumbria.
Project aims:
• Develop a strategy for the delivery of a WSA for females in
Lancashire and Cumbria.
• Increase connectivity between strategic programmes of work
which either directly target female offenders and / or women
with multiple and complex needs to strengthen WSA provision
• Improved articulation, appreciation and understanding of the
role that gender plays in offending, vulnerability and
rehabilitation.
• Sustained investment into the WSA through more aligned /
pooled budgets

37. The Project Working with You
Improved articulation to strengthen stakeholder understanding regarding the role that
gender plays in offending, vulnerability and rehabilitation
• Criminal Justice
• Health
• Local Authorities
• Other stakeholders
• Transformation Projects
• Other programmes of activity (Health & Wellbeing Board, Criminal Justice Board)
• Opportunities with other third sector organisations

38. What are we finding? Sharing Insights from our Work to
Inform Prevention
• Approach Overview - Penelope D’Souza, Deputy CEO
• Supporting Women at Risk: Learning from ACE and Needs Data – Karen
Carter, Women at Risk Programme Manager
• Money, Debt and Welfare – Mandy Taylor, Employment Advice and
Guidance Programme Manager
• Perinatal Mental Health – Tracey Marsden, Perinatal Programme Lead

39. Approach Overview
Data
Design
Data
Collection
Data
Storage
Data
Analysis
Evidence
Legislation,
Compliance

40. Supporting Women at
Risk: Learning from
ACE and Needs Data

41. What our Data Tells Us
• Lifetime Experiences/Current Circumstances
• Adverse Childhood Experiences (ACE), Budgeting, Housing, Family, Support network, Mental
Health, Physical Health.
• Mapping the Journey Through our Services
• Engagement, Support/Services accessed, Improvement in Lifestyle and Community
Integration.
• Why?
• Contractual Obligations
• Service Development
• Action Planning

42. Service User Feedback
I can be open with my
worker because she
does not judge me and
this has helped me be
confident
Coming here has saved
my life, I wish I would
have known this help
was available before I
got in trouble
I opened up and was
listened to, I now like
myself and know I can
make changes
Learning that I'm not
the only one with
problems and that I'm
not on my own and
that there is help and
support available
I have contact with my
kids and I never thought
I would get that back

43. How can we Better Use our Information?
• What do we want to know
• Where do we start (ACE)
• 80% of women with an ACE of
zero have had no issues with
engagement.
• 75% with a score 1-3
• 60% with a score over 4
• Categorising risk of none
engagement is complex and
must consider multiple factors.

44. Developing a Bigger Picture
• 51% of women with a ACE score of zero who have difficulties
engaging expressed that they have experienced thoughts of suicide.
• Comparatively 27% of those who do engage have disclosed they have
experienced suicidal thoughts. What is different?
• 81% of women who score four or more and have difficulties engaging
expressed that they have experience thoughts of suicide.
• Comparatively 25% who do engage well have disclosed they have experienced
suicidal thoughts. What is different?

45. What Next?
• Further work to develop an understanding of what our data tells us.
• What will we do with the initial findings?
• Resilience
• Future evaluation

46. Employment Advice and Guidance
Mandy Taylor

47. Identifying Needs
• Growth of service
• Numbers 2016/2017 – 880
new people accessed
LWC Money Advice
Service
2016/2017 – 1276
individual Money
advice sessions held

48. Presenting Issues

49. Presenting Issues

50. Evidence/Impact
• Service demand doubled during 2014 - 2017
• High numbers of families on benefits or low income
• 479 children living within the families needing money advice in Blackburn
alone
• Volume of benefit sanctions & being found fit to work - increased 52% ESA
appeals won
• Foodbank referrals have increased and will continue to with transition to
UC
8,642 three-day emergency
food supplies given to
people in crisis last year
(BWD Food Bank)

51. Changes & Impact
• FCA authorised and feedback in to data collections
• Local knowledge strategically fed into local government
• Evidence is fed back to National Audit Team
• Attendance at DWP events to share best practice
• Membership of local advice networks
• Partnership working to ensure needs are met
• Links with other Services – Safeguarding, Police and Foodbanks
• Less crisis more prevention and intervention.
Financial gains 16/17 -
£1,461,254.78

52. Service User Feedback
Felt more at ease after my
appointment
Was very helpful and kind
explained everything
clearly so I could
understand am very
grateful for the help.
Listened which is less
common than you would
think
‘Not being made to
feel like a looser’
Happy with the
service, helpful,
informative, very
clear and would use
again
Helped put my mind at ease sorted out my
money problem, helped with my claim and
put me in touch with someone to help me
find a job

53. Evidence
• The best evidence is that of our service users.

54. Perinatal Mental Health
Project Lancashire and South
Cumbria

55. LWC Data (April – June 2017)
12 clients with child under 1 year
8 female - 4 male
2 pregnant
1 client - partner was pregnant
5 clients - 0/3months old (2 males)
3 clients - 6/9 months old
1 no information recorded
6 suffered anxiety or depression
4 stated childhood trauma
3 historic family issues
1 previous PND
None had ACE assessment completed.

56. Initial Findings
• Recording of accurate data
• VIEWS
• IAPTUS
• Commissioning requirements
• Consistency (IAPT sub group)
• Improved education
• Vulnerabilities
• Routine Enquiry - ACE
• Father’s wellbeing

57. Workforce Development
Health Visitors
Midwives IAPT
CHAMPIONS

58. Considerations
• Consistency
• Lack of forward facing information
• Family friendly services
• Decision making tools and resources including Routine Enquiry (ACE)
• Home visits
• Use of community venues
• Improved physical and virtual communication operationally to share good
practice

59. Neonatal Intensive Care Parental Support Study

60. It would have been
helpful to share my
fears with someone
other than my
partner
I needed to feel
supported when I
was at home with
my baby I think NICU should have
specialist bereavement
support, I felt my whole world
had crashed down, I was
scared lost and broken.
Need help with
supporting parents
emotionally
Ensure fathers are
included more in
the care of the
baby
Pathways for
onward referrals in
the community
What do STAFF and PARENTS think?

61. What Next?
• Continue being a connector
• Avoid silo working
• Peer support networks
• Support sessions within NICU and Bump, Birth and Beyond
• Build on existing good practice locally and nationally
• Link in with Integrated Care Pathway
• Advocate on behalf of those with lived experiences strategically
• Share expertise, knowledge and educate
• Ensure that the views of parents are heard and listened to

62. As asset based approach – realising the value of community in
our delivery
• Our Service User Engagement Approach – Liz Islam, Head of Business
Development
• Peer Support, Sharing Best Practice - Jo Bates, Psychological
Wellbeing Practitioner

63. A Service User Led Organisation?
Managing Connections Through Change and
Growth

64. Our Strategy
Our Aim
We will put services users at the heart of everything we do
Objectives
• To ensure that service users have the opportunity to actively participate in the coordination and
planning of the support that they receive to assist their own ‘recovery’ journey.
• To provide service users with appropriate support and guidance so that their experience of
engaging in opportunities to influence, deliver and lead services at LWC is safe, enriching and
empowering.
• To develop innovative and new methods to enable women to play a greater leadership role in the
organisation.

65. Starting from the Top
• Reviewed current methods and opportunities for service user
participation
• Reviewed all points on the participation journey
• Recognised our resources - a simple strategy which is a work in
progress
• Collective ownership
“We will put service users at the heart of everything we do”

66. What did we find?
• Leadership and development
• We value lived experience in our workforce
• 45% of staff had volunteered prior to employment
• 28% had accessed services at LWC
• 12% of staff have progressed through a complete journey of
accessing support, volunteering and then paid employment
• Involving service users in planning their support
package
• Peer support - Low cost (but not no cost) / High
Impact
• Relationships

67. Relationships
“Clients can tell - even without personal disclosure - if you have lived experience and it
makes the support they receive from us more real and valid”
“Having been out of work, struggling with mental health myself, I feel this gives me a better
understanding of what my clients are going through and I feel compassion for the ladies
that I work with- which leads to better engagement from the service user, in my opinion.”
“When I have made mistakes my Caseworker has always been understanding, but firm at
the same time. I like that the truth isn't sugar coated and that my options are always
clearly laid out for me.”
“We believe in what they say and their experiences”

68. Are we there yet?
• Bringing together the needs of our
service users, our team and our
commissioners
• Staff and Volunteer Wellbeing
• New methods for voice
• Always more we can do….

69. Next Steps
• A living process - regular reconnection
• Using all opportunities to bring local service user voices to commissioning
and transformation plans – key in devolution and STP
• Developing expertise in this area
• Understanding that service users are not ‘other’ but all of us, at any time

70. Peer Support
Better Together

71. Our Current Peer Support Offer
Groups that are LWC organised and volunteer facilitator led:
Coffee Tastes Better Together - Walking Group - Friendly Fridays –
Chrysalis - Coffee, Colour and Connect – Craft Groups – Walking Group – Noise Machine
Self-facilitated groups that have emerged from LWC organised groups:
The Flyers – The Bridge – Hip to Knit – Gardening Group
Taking place everyday this peer support is informal and is defined by there
being no official responsibility by the support givers:
Clients meeting externally - Clients supporting each other in the centre e.g. Work Club
Co-Ordinated Support
Learnt Support
Instinctive Support
‘Interacting with others’ is a benefit of
attending peer support services

72. Our Lightbulb Moments – Lessons Learnt
Friendly Fridays had too much leadership, leading to a reliance on the facilitator rather than
each other
> Importance of getting the balance of the facilitator’s role correct
Coffee Tastes Better Together - Lacking in longevity in some centres as
format/contents were too rigid
> Know your community - what are the demographics? What peer support is already
available? One size does not fit all.
Successful groups provide opportunities for clients to grow and develop, as
evidenced by a reduced need for contact with the centre – like offspring flying the
nest
> ‘It came from within’ – giving clients opportunities for growth allows them to shine !

73. Looking Ahead
• Supporting Communities across Lancashire – The Culture Club
• Show off and Share groups – Will look different in each locality. A
community feel using assets of individuals within the community -
to develop creative, cohesive communities
• This project is in development following review of what has
worked well in groups – recognition of peer support - what it
provides - it’s an organic process

74. Key Learning – That Certain Someone !
Peer Support Facilitating is a specialist role and requires:
Lived experiences: The need to comfortably recollect personal experience and use that
insight to develop healthy discussion and exploration
Self-awareness: Knowledge of personal stressors, possession of personal resilience
strategies, know ledge of areas of strength and areas which require attention
Support: A strong desire to help others. Supporting and interacting with people is a way of
life !

75. What our Clients Say…
Somewhere I can
talk and not be
judged
Somewhere
where I am not
alone and
isolated
Letting go of
the volcano
– talking
things
through
Somewhere to discuss
mental health problems
Fun

76. Summing Up, Sarah Swindley CEO

77. What makes me proud…
• Lives saved and changed forever, impact on future
• Ability to connect, fill in the gaps
• National profile – taking voice of Lancashire women to speak truth to
power
• A team full of passion, going above and beyond. Improving terms and
conditions, staff valued and secure.

78. What keeps me awake at night…
• Work still to do
• Nervousness to talk about gender, about women, misunderstandings about
equality.
• Voice of Lancashire communities lost in regional and central conversations
• Brexit – ESF and employment
• Impacts for women not quantified and likely compounded, history tells us.
• Ability to horizon scan

79. What have I learnt…
• People are mainly kind, helpful and want to make a difference
• Most decisions are filtered through a concern for own job security, at
all levels. Removing this filter is essential for system change.
• Thinking and planning space and time is not a luxury but a necessity.
• Leadership is a way of being and can be lonely.
• Women working together for other women achieve amazing things.
• Collectively we have the answers, but not always the power

80. Thank You and Goodbye
• Annual Report - Circulation WC 25th September, all attendees will receive a
copy
• Follow us on Twitter and Facebook
• To be put in touch with any of our Programme Managers to hear more
about specific programmes & projects please contact:
Liz Islam, Head of Business Development liz.islam@womenscentre.org