Embedding Early Intervention within the Commissioning Pathway Ian Curryer, Corporate Director, Children and Families Candida Brudenell, Director, Quality and Commissioning Chris Wallbanks, Programme Manager, Early Intervention and Partnerships

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Embedding Early Intervention within the
Commissioning PathwayIan Curryer, Corporate
Director, Children and FamiliesCandida
Brudenell, Director, Quality and
CommissioningChris Wallbanks, Programme Manager,
Early Intervention and Partnerships
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Purpose

• To provide an opportunity for leaders from
  across the region to engage with leaders from
  Nottingham, explore their approach and share
  learning from their experience.

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Programme

• Nottingham as an Early Intervention City Ian
• Developing the Commissioning Pathway Candida
• Early Intervention within the Commissioning
  Pathway Chris
• Considering the challenges and sharing practice
  All
• Embedding Early Intervention Candida
• Examples of shifting resources All
• Next Steps - All

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Nottingham City

• High levels of deprivation high spending LA
• Strong Nottingham Plan and CYPP
• Ofsted Inspection of Safeguarding and Looked
  After Children Services December 2010
• Nottingham hasan extensive and outstanding
• range of early intervention services, making a
• marked shift with vulnerable children and
• families

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Nottingham, Early Intervention City

• Our aim is to break the intergenerational
  nature of underachievement and deprivation in
  Nottingham by identifying at the earliest
  possible opportunity those children, young
  people, adults and families who are likely to
  experience difficulty and to intervene and
  empower people to transform their lives and their
  future childrens lives

• Programme approach
• Governance
• Pilot projects
• Learning and Evaluation
• Knowledge
• Finance

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Learning from the EI Programme

• Think like a Partnership
• Joined-up decisions and an integrated workforce
• Use the F word Fidelity
• Roll-out evidence-based programmes properly
• Engage the right families
• Evaluate and build your evidence-base
• Standards of evidence and evaluation
• Seek first to understand
• Insight whats really happening?
• Costs know them!

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Using EI principles to change our systems and
structures

• Family Community Teams
• Family Support Strategy
• Workforce Core Standard - consistency
• CAF target groups
• Thinking more holistically around complex
  families
• Corporate parenting is everybodys business

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10 year profile of one complex family
Key points Escalation Non-engagement Inter-genera
tional Symptom not cause Silo focus Child focus
not family focus High cost but outcomes getting
worse
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Family Community Teams
Local Team Delivering Universal Additional Support Single point of access for Extensive Support
Children Centres Play Youth services Child and Adolescent Mental Health Services Family Support Teams Education Welfare Educational Psychologists Disabled Childrens Service Youth Offending Team
Link to Partner Community Services
Area Management Police Midwifery Health Visitors Job Centre Plus Voluntary and Community Sector Extended Schools Leisure Education Improvement Partnership
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Early Intervention
starts early as soon as potential difficulties
are identified and...
...requires good assessment of need that should
form...
a comprehensive, purposeful response
to tackle problems
www.mynottingham.gov.uk/familysupport Or http//ww
w.nottinghamcity.gov.uk/ics/index.aspx?articleid1
4713
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Discussion

• In pairs, discuss what the term commissioning
  means to you.
• As a group, record your shared definition on the
  flip chart paper and stick to the wall or window.

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Commissioning

• means outsourcing
• ...is about meeting your sales target
• is getting someone to do some art for you
• ...is a structured needs based approach to
  identify your service

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Commissioning

• is more than just about children
• is the whole process of designing and
  resourcing service provision. Who we deliver to,
  how much it will cost
• ...is about the life cycle. People often confuse
  it with procurement
• is an urban myth
• About half of our senior managers had an
  understanding of commissioning, but thought it
  related to EXTERNAL services only.

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Our Commissioning Journey.

• Commissioning Framework agreed in 2010 by the
  Council and One Nottingham
• Not just the diagram! Details, tools and
  explanation on the website

• Strong collaboration between partners and in
  particular the Voluntary and Community Sector

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Our Commissioning Journey.

• Underpinned by principles including
• Early Intervention
• Local Jobs for Local People
• Supporting a thriving 3rd Sector

• During 2010 Children and Families was
  reconfigured to bring together Adults and
  Childrens Commissioning
• Framework translated into a pathway
• First set of commissioning intentions
  identified

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Strategic Commissioning Intentions origins
Improved outcomes for citizens Reduced
costs Greater investment in prevention and
EI Improved pathways Improved Efficiency
Commissioning Pathway
Strategic Commissioning Intentions
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Commissioning Pathway
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EI within the year 1 reviews
Analyse
Plan
Do
Review

• 85 population to inc by 45 by 2030
• Budget 42.3m
• High use of residential
• High placement costs
• People lose skills in resi
• Citizens feel isolated but want to remain
  independent

• Consider EI models
• Involve partners and citizens
• Establish Business Cases
• Agree budgets
• Finalise details

• Procure/implement new models of delivery
• Monitor and evaluate progress quarterly
• Measure impact annually
• Adjust where appropriate

• Client group feedback
• Measure longer term impact
• Evaluate the process
• Inform stakeholders and the market what works and
  what we want more of

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EI Phase 1 Programmes

• Nottingham Circle
• Living Support
• Networks
• Expansion of Telecare
• Service
• Reablement Gateway

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Low cost/no cost options
Needs Low level support in community Friends and Family Equipment and telecare Reablement Alternatives to resi care (supported housing) Crisis / rapid response service
Shopping
Cleaning
Food and drink
Social Contact
Personal Care
Medication
Parenting
Financial Planning

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Year 2 Reviews

• Safe from Harm
• Complex Families
• Social Exclusion
  

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Discussion

• What do you believe to be the key challenges in
  driving the EI agenda through the commissioning
  process for
• Providers?
• Commissioners?
• How is your organisation meeting these challenges?

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Embedding EI into Commissioning

• Base lining financial split
• Engaging Councillors
• Identifying a shift
• Pump-priming, but identifying the mainstream
  budget
• Focus on clear evidence-based programmes
• Scale up what works

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Discussion

• What examples can you share of how you are
  shifting resources to Early Intervention?

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Next Steps

• What can Nottingham do to support you further?
• What can JRIEP do to support you further?

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• Thank you
• For further information contact
  chris.wallbanks_at_nottinghamcity.gov.uk
• Website - www.nottinghamcity.gov.uk/commissioning