INVOKE

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INVOKE

• IN dependence through the
• V oluntary action
• O f
• K ents
• E lders

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INVOKE is

• A 2 year Department of Health funded project
  (April 2007- March 2009)
• An East Kent only Project covering the Districts
  of Ashford, Shepway, Canterbury, Dover, Thanet
  and Swale, and the Eastern Coastal Kent Primary
  Care Trust
• A round two Partnerships for Older Persons
  Project (POPPs)
• One of 12 Local Authority Projects that has been
  successful in round two.

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INVOKE POLICY CONTEXT

• Active Lives - a 10 year vision (KCC, 2004)

• District Business Plans

• Our health, our care, our say (DOH, 2006)

• Kent Compact

• Strong and prosperous local communities (DCLG,
  2006)

• Public Service Agreements

• Local Area Agreements

• Integrated Service Improvement Plans (Health)

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INVOKE is an East Kent Project that aims to

• Increase independence through the delivery of
  local services to its communities, enhancing
  self management through increased choice and
  control
• Reduce emergency admissions to hospital
• Support older people to live at home by
  increasing community services that support the
  long-term condition agenda
• Increase the individuals wellbeing by providing
  an information resource, a brokerage service and
  hands on care and support

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This will occur through the creation of 3 new
staff positions

• Community Matron Support Worker
• Community Information and Liaison Assistant
• Care Navigator

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Community Matron Support Worker (CMSW)

• will undertake a delegated case load to support
  clients, with health social needs. The service
  will not be age related and accessible to all
  those who are eligible and in receipt of the
  Community Matron service.
• Three workers in each of the Adult Social
  Services District, 18 in total.
• Employed by the Eastern and Coastal Kent Primary
  Care Trust (ECKPCT).
• will undertake clinical skills such as
  venepuncture, blood glucose monitoring, etc.
• will have competency based training in
  rehabilitation skills to deliver health
  promotion, thus improving physical,
  psychological, social and emotional wellbeing.
• Telehealth monitoring.
• Increase existing capacity with Community Matron
  caseloads through the delegation of cases to
  Community Matron Support Workers, freeing up
  Community Matron time to enhance service delivery.

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Community Information and Liaison Assistant
(CILA)

• One Community Information Liaison Assistant
  based in each Adult Social Services District, 6
  in total.
• Employed by a Voluntary Sector Organisation
• Role includes
• the creation of an information resource, to
  enable a point of reference that community
  members can use, to direct themselves to
  appropriate services through self management.
• The facilitation of ad-hoc activities/ sessions
  that support health promotion and independence,
  such as seated based exercise programmes. These
  will be organised based on the District needs
  indicated.

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Care Navigator (CN)

• One Care Navigator in each Adult Social Services
  District, 6 in total.
• Employed by a Voluntary Sector Organisation.
• Referral via statutory, voluntary, and private
  providers as well as direct access.
• Role supports
• Undertaking personal action plans with
  individuals to support need resolution, where
  able, through a non-advocerial service.
• A short term intervention over a series of three
  contacts.

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Service Progress

• Community Matron Support Worker
• Recruited 17 of 18 posts
• Commencement of service 3rd September onwards
• Job description and person specification agreed
• Service Specification - version 6 out to
  consultation
• Induction and training - format included with
  service specification
• Financial process clarified

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Service Progress

• Community Information Liaison Assistant
• All 6 contracts awarded
• Service Specification agreed
• Job description and person specification agreed
• Staff recruitment anticipated 1st November
  onwards
• Induction and training manual, and service
  leaflet will be created through the CILA
  Development Group
• District CILA forums created to support delivery
  of information resource

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Service Progress

• Care Navigator
• 5 contracts awarded
• Re-advertised for 1 District due to lack of
  interest
• Job description and person specification agreed
• Service Specification agreed
• Service leaflet agreed
• Induction and training manual framework created
• Care Navigators in place approximately 1st
  October
• Action planning document finalised
• Referral form finalised

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Local Evaluator
Local Evaluation of the Kent POPP
ProjectPersonal Social Services Research Unit
London School of Economics and Political Science
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Local Evaluator

• Research questions
• To what extent has INVOKE supported the
  reduction of inappropriate emergency admissions
  to acute hospitals (the LTC target of the POPP
  initiative)?
• To what extent has INVOKE supported an
  increase in the proportion of older people living
  in their own homes and a decrease in the
  proportion entering long-term care (the OP PSA
  target of the POPP initiative)?

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Local Evaluator

• To what extent and in what ways have users of
  the INVOKE services/interventions benefited?
• To what extent has INVOKE altered local
  patterns of expenditure and proved to be
  cost-effective?
• What impact has INVOKE made on joint working
  between the voluntary, health and social care
  sectors in East Kent?

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Local Evaluator
The evaluation will also describe the links
between the three strands of the local
initiative what service gaps the new support
services are designed to fill what links they
are anticipated to have with existing services
and what links they prove to have in practice.
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Local Evaluator

• Methodology
• quantitative
• routine data collection (LA NHS)
• qualitative -
• semi-structured interviews with
• key informants-KCC, PCT, VCS
• front-line staff - CMs CMSWs CNs and
  CILAs
• users - 40-50 interviews

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Local Evaluator

• Quality of Life measure
• to concentrate this on those receiving the
  Community Matron Support Worker (CMSW) and
  Community Navigator (CN) interventions
• we aim to sample approximately 100 people from
  those supported by INVOKE

• a simple satisfaction questionnaire will be
  administered to the Community Information
  Liaison Assistant

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Financial Risks

• Projected costs exceeded
• Diversity of provider expectations which include
• management costs ranging from 300 to 4,662 full
  year
• expectation of demand on internal management has
  not reflected Peer Support Group and Project
  Board role
• understanding of financial breakdown terms
• Understanding of format, particularly tender
  documentation
• Clear and explicit exit strategy
• Collaborative approaches - lead Voluntary Sector
  Organisation will carry financial risk if an
  overspend position arises

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Financial Risks

• Original format of Service Agreement enabled up
  to 2k per year under-spend to be held by the
  Voluntary Sector Organisations, with caveat that
  this would be spent on a Project with a similar
  ethos. This has been removed for the purpose of
  this Project to enable all under-spends to be
  drawn back into the Project and support
• Slippage protocol will act as a buffer to support
  equality of access to under-spend through an
  agreed process with final decisions in regards to
  award being made by the INVOKE Project Board

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Financial Lessons Learnt

• Collaborative approach between Voluntary Sector
  Organisations has been taken in some Districts
• Need to consider historic payment methods between
  the two parties and expectations
• Financial and contractual existing formats may
  need to be changed to better fit. Within the
  Project we varied our Business Questionnaire
  (tender document) and Service Agreement
• Discuss openly suggestions (with partners) prior
  to re-visiting to secure early agreement and
  universal understanding . Actual Statement of
  Expenditure document has been created to report
  actual expenditure in year one to enable
  adjustment in year two.

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Financial Lessons Learnt

• Consider financial audit and public
  accountability. Create documentation to support
  process early to secure agreement and
  understanding
• Diversity of experience within not-for-profit
  organisations and thus some are potentially
  disadvantaged and less likely to engage
• Upon conception of roles, discuss with likely
  providers to gauge a likely costing of the
  post/ service. This enables a relation to pay
  salaries that fit within their existing staff pay
  salaries, which are diverse due to local
  commissioning arrangments

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Financial Lessons Learnt

• Consider agreeing a pay salary that will enable a
  universal pay salary across the service and thus
  equality of pay
• Existing procurement procedures indicate a
  non-collaborative approach in regards to
  providers discussing tender costs to avoid cartel
  position. At times this may disadvantage both the
  Local Authority and providers
• Creation of clear financial and procurement
  procedures and policies that fit the market you
  are addressing. This work could support universal
  adoption of an agreed management cost of X,
  standardisation of other costs such as IT
  equipment etc

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Public Patient Involvement

• Inclusion has included a proactive role across
  the Project which has included
• Development Group membership
• Interview Panel
• Tender Panel
• Service User References

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Value in using PPI
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Value in using PPI
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PPI Lessons Learnt

• Need for Local Authorities to consider how we can
  better enable a meaningful PPI through the
  delivery of training / experiential learning such
  as
• interview techniques
• dictionary of Health Social Care terminology
• contract awareness
• considering policies and procedures being
  contextualised in a more PPI friendly format that
  would enhance their engagement and provide staff
  guidance in regards to specific areas I.e. PPI
  tender panel membership
• worth considering if existing policies and
  procedure offer guidance in regards to support of
  PPI engagement. Do they need to be updated to
  enhance value?

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Personal Learning

• Need to identify lead personnel early on
  (internal and external)
• Pre-submission
• consider a contingency budget to support
  shortfall, if affordable
• consider support requirements
• How complicated financial processes are! Do you
  know enough?
• Exit Strategy - defining the term!
• Prepare Partners Practitioners
• Writing own job description
• Capturing lessons learnt - be ready for next time!

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Key Contacts
Dawn WoodwardProject Manager St Peters
House Dane Valley Road St Peters Broadstairs Kent
CT10 3JJ Email dawn.woodward_at_kent.gov.uk Telep
hone 01843 860000 ext.2226 Michele
Cocklin Project Administrator Email
Invoke01_at_kent.gov.uk Telephone [phone] ext.
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