public service reform – rochdale borough...
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Public Service Reform –
Rochdale Borough Implementation Plan
April 2013
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Public Service Reform in Rochdale
1. Introduction
Partners in Rochdale Borough have a highly aspirational strategic intention to reduce public service spend, dependency, and worklessness and
to improve self-reliance, independence and the overall quality of life for all its residents.
Partners do not under estimate the challenge that this presents but equally realise that there is an unprecedented opportunity in these
difficult times, to invest in success not failure, to integrate our plans and services much more than we do already and promote economic
growth and work opportunities within our borough and across Greater Manchester.
Partners are committed to working collaboratively and in the spirit of cooperation to ensure a more sustainable and radical difference in the
way we deliver services. They are committed to working collectively on a programme of public service reform the initial phases of which are
included in this implementation plan.
This plan sets out the beginnings of our public sector reform work in the borough and will in time, include other areas of transformation and
reform. The plan acknowledges progress to date and highlights those areas in which integrated working is taken to a new and increased level ,
reducing demand and improving user experience . It acknowledges the work to be done in developing the sensitive and complex area of new
investment models which details the savings to be made and allows a reallocation of resources following intended reduced demand and the
development of robust evaluation aimed at demonstrating value for money and the cost effectiveness of new ways of working which will aid
the process of agreeing priorities and focus for future investment.
The plans details the who, what, when and how services will be transformed across five themes. It features a number of enabling themes
developed to cut across the themes and to ensure a coordinated and streamlined approach particularly in relation to work force development,
evaluation and performance management linking into the Greater Manchester approaches which make sense on a wider geographical
footprint
2. Working together across Greater Manchester
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Rochdale boroughs public service reform programme supports and underpins the public sector reform objective in the Greater Manchester
Strategy. The test for both authorities is to continue to develop strong relationships and shared understanding and to juxtaposition these
together seamlessly maximising those transformational elements which can be done most effectively at GM level and those at district level
which can best meet need locally.
3. Public Service Reform in Rochdale Borough
Partners have set up a Public Service Reform Board which provides overall governance for the programme and drives the public service reform
borough wide offer. The Board maintains focus and momentum, provides strategic overview, guidance and direction. A Community Budget
Officer Group is in place to challenge, co-ordinate and knit together an integrated package of reforms. Individual partnerships shape a deliver
work streams.
Democratic input is guaranteed through portfolio members providing challenge and support and championing the work streams. The council’s
Cabinet provides the political overview of the programme and its development. The council’s Overview and Scrutiny Committee will challenge
the programme and its eventual impact.
The core of public service reform in the borough derives from a family centric approach, which features whole systems working and a
significant focus on our most complex families. This includes those hit worst by welfare reform and young men included in the intensive
alternative to custody cohorts. These “customers” provide a significant opportunity to increase and develop services which instil
independence and improve the life chances of some of our most vulnerable and challenging people in our borough.
Programme governance is detailed diagrammatically below.
4. Plan Sign Up
This Implementation Plan has been signed off and is endorsed by:
• Members of the Boroughs Public Service Reform Board, including Chairs of the Thematic Partnerships
• Appropriate Councillor Portfolio Holder
• Partnership Appropriate Boards ( including Chairs )
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• Local PSR Theme Champions
• Lead Officers, tasked with delivering key projects (where otherwise not represented)
Name Role Signature
Rochdale Borough Public Service Reform Board
Jim Taylor Chair
Councillor Colin Lambert Leader RMBC
Annette Anderson Chief Superintendent GMP
Tony Lander Borough Commander GMF&RS
John Saxby Chief Executive Pennine Acute
John Archer Chief Executive Pennine Care
Lesley Mort Chief Executive HM&R CCG
Gareth Swarbrick Chief Executive Rochdale Borough Wide Housing
Craig Mc Ateer Chief Executive Links 4 Life
Sheila Downey Executive Director Adult Care RMBC
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Jane Rossini Director of Public Health RMBC
Nigel Elliot Acting Assistant Chief Executive , Greater Manchester
Probation Service
Kathy Shaw Chief Executive Rochdale Council for Voluntary Service
Gladys Rhodes- White Interim Director Children’s Services RMBC
Linda Fisher Deputy Chief Executive RMBC
Appropriate Councillor Portfolio Holder
Councillor Donna Martin
Children Schools & Families
( Early Years and Stronger Families )
Councillor Sultan Ali
Strengthening Communities
( Transforming Justice)
Councillor Colin Lambert
Leader and Health
( Health & Social Care)
Councillor Peter Williams
Economic Development & Customer Services
( Worklesseness and Skills)
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Partnership Appropriate Boards
Dr Chris Duffy Health & Well Being Board
Councillor Donna Martin Children’s Partnership
CS Annette Anderson Safer Community Partnership
Stuart Sawle Economic Alliance
Local PSR Theme Champions
Amanda Jackson Troubled Families Lead Officer
Sheila Downey/ Lesley Mort Health & Social Care Lead Officers (RMBC/CCG)
Helen Chicot Work & Skills Lead Officer ( RMBC )
Mohammad Yunus/
Jeannette Staley Transforming Justice ( GM Probation )
Laura Beesley Early Years Lead Officer (RMBC)
Janet Ainscow/ Julian Massel
/ Julie Murphy/ Susan
Blundell/Linda Fisher
Cross Cutting/Enabler leads
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Local Programme Governance
Council
PF holder Early Years
PF holder T Families
PF holder T Justice
PF holder H & Social Care
PF holder Work & Skills
Cabinet
Council Governance
Local Public Service Board
CB Officer Working Group
Children’s Partnership
Safer Communities Partnership
Health & WBB
Work & Skills Advisory Group
Partnership Governance
GM Combined Authority
WLT PSRE PSR Executive
H&SC
GM H&WBB
Early Years
Early Years Exec
T Families
T Families Exec
T Justice
T Justice Exec
Work & Skills G
GM Governance
5 Themes & Enablers
Leadership T
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Early Years
1. Summary
40% of children in Greater Manchester (GM) are assessed in reception class each year as not being ready for school. This represents 16,000 children each
year who are on a poor life trajectory from the outset, unable to engage with the national curriculum effectively and at risk of never catching up. These
children are less likely to reach their full potential at school and, ultimately, less likely to be economically active and productive. Conversely, many of them
are likely to place a high demand on public services throughout their lives.
We need to generate sustained improvements in outcomes for Early Years by increasing the number of children arriving at school ready to engage in the
curriculum.
The new delivery model consists of:
1. A shared outcomes framework, across all local partners;
2. A common assessment pathway across GM: eight common assessment points for an integrated (‘whole child’ and ‘whole family’) assessment at key
points in the crucial developmental window, using expanded existing assessment points, and with the remaining HCP visits to continue as standard;
3. Evidence-based assessment tools to identify families reaching clinically diagnosable thresholds for intervention or having multiple risk factors as early as
possible;
4. Needs assessment triggers referral into an appropriate evidence-based targeted intervention;
5. A suite of evidence-based interventions is being developed, to be sequenced alongside other public service interventions as a package of
transformational support to families, with appropriate step-down packages of support rather than ‘free fall’, to help off-set the risk of re-entry to a high
level of need in future. Areas will be able to ‘top up’ the suite of interventions with additional services according to local circumstances;
6. Ensuring better use of daycare: new ‘contract’ with parents eligible for targeted twos daycare to drive engagement in
education/employment/training/volunteering, and introducing new common terms and conditions to drive improvement in all daycare settings;
7. A new workforce approach, to drive a shift in culture: enabling frontline professionals to work in a more integrated way in support of the ‘whole family’
and with other services to collectively reduce dependency and empower parents;
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8. Better data systems to ensure the lead professional undertaking each assessment has access to the relevant data to see the whole picture, to reduce
duplication and confusion, to track children’s progress and in particular support the most vulnerable and disadvantaged;
9. Long-term evaluation to ensure families’ needs are being addressed and add to national evidence for effective early intervention.
A new investment model is required to implement the new delivery model in full.
• Initial estimate that around £300m pa is currently spent on Early Years services across GM, principally health (£175m) and local authorities (£120m).
• Initial estimate of the additional costs of implementing the new delivery model across GM is £38 million per cohort over five years. Benefits are
estimated at £45 million over five years.
• Further work is currently being undertaken to verify where the benefits are likely to fall. The key beneficiaries after five years are DWP / HMT, Health
and Local Authorities. After 25 years, the distribution of benefits changes with DWP / HMT benefitting the most.
• Work is under way to develop the business case into an investable proposition. This will require a detailed review of the above estimated costs and
benefits.
Evaluation: Individual interventions within the Early Years new delivery model have a strong evidence base, but there is not currently strong evidence for
the model as a whole. Given the length of time it will take to generate impacts and ultimately a return on investment, Initial investment will have to be at
considerable risk. Implementation of the model should be accompanied by a 25 year longitudinal study to track the additional impact of NDM over time
Who is leading this work in Rochdale?
The Lead for Rochdale is Laura Beesley, Sure Start Team leader
The GM theme lead is Pat McKelvey [NHS GM]
What does success look like?
Success for the Early Years theme will be the increased number of children achieving a good level of development as measured by the Early Years
Foundation Stage Profile assessment by 18%, benefitting 22,000 additional children and exceeding the national average by 10%.
In Rochdale the same measure will be used and a trajectory will be set to reach the AGMA wide target in the same timescale.
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What are the milestones for implementation in Rochdale?
• Multi-agency engagement and accountability process established and working effectively May 2013
• Assessment made of evidence based interventions. June 2013.
• Mandate agreed for collection of quality assurance and data information by Children and Young People’s Partnership Sept 2013
• Sign off Local Authority revised Terms and Conditions September 2013-03-22 Draft contract with parents agreed Feb 2014
Districts and partners are already contributing to further developing the new delivery model, investment approach and evaluation, including defining:
• The standardised set of assessment tools from pre-birth to starting school, used by all of the early years workforce
• The common suite of evidence based interventions and statutory services - and decommissioning other interventions no longer required
• Common terms and conditions to ensure compliance with the NDM
• GM early years parental contract linking daycare to universal credit
• Common terms and conditions for free entitlement funding
• Shared outcomes framework
• Data hub that will enable sharing of intelligence and information across partners
• Investment of resources as set out in the investable proposition
• Shared performance and evaluation approach that will underpin a longitudinal study of the cohort over 25 years
• GM-wide workforce agreement and training programme
• GM-wide commissioning and procurement framework
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Action Number Early Years Local Delivery Plan Lead
Officer
Part of
GM
Action
April
2013 –
June
2013
July
2013 –
Sept
2013
Oct
2013 –
Dec
2013
Jan
2014 –
March
2014
April
2014 –
Jun
2014
July
2014 –
Dec
2014
2015
EY1
Process
required to
deliver
Ensure representation from Rochdale on all work
stream groups, project steering group and executive
group
Set up regular internal feedback meetings to ensure
all members are briefed and linkages are made
between the key themes and steering group.
Set up multi agency group with midwifery and health
visiting services in first instance
Ensure joint commissioner is fully involved in
Rochdale work
Laura
Beesley
Laura
Beesley
Laura
Beesley
Laura
Beesley
/ Karen
Kenton
Yes
Yes
April
April
April
April
EY2
A standard set
of assessment
tools from pre-
birth to starting
school, used by
all of the early
years workforce
EY2.2.First
Stage
methodology
agreed
EY2.1
Set up multiagency group to survey existing
assessment tools in Rochdale and identify which
maybe in line with NDM
Ensure Rochdale’s views inform the work stream
When decisions are made on tools ensure
implications are considered
NB This will have an impact on children’s workforce
training across all partners. It may also have an
impact on funding if copyright training packages are
required
This stage is pre-natal and will be agreed with
midwifery service
Gail
Hague
Reps
Laura
Beesley
Laura
Beesley
Gail
Hague
Yes
Yes
Yes
Yes
May
April
May
July
12
EY2.3
Stage 7/8
assessment in
place
Identify key parties e.g. Children’s Centres,
Childcare providers, schools and build on exiting
Rochdale policies and protocols.
Develop a protocol for assessment stage and ensure
all partners have signed
Consider the development of the GM agreement of
DSG funds to be placed in an expectant grant
protocol.
Incorporate assessments actions and methodology
into DSG grant conditions
Gail
Hague
Gail
Hague /
Laura
Beesley
Laura
Beesley
Laura
Beesley
Yes
Yes
Aug
Sept
Oct
Oct
EY2.4
All 10 local
authorities have
an agreed
mandate and an
agreed process
in place for
collection/QA of
data to be
submitted
Draft process to be consulted upon
Final mandate approved by Children’s and Young
People’s Partnership
Laura
Beesley
Yes May
June
EY2.5
QA/Moderate
data submission
Active participation in the decision on QA and data
submission
Engagement of key partners including data/IT,
performance management to ensure systems in
Rochdale can support submission criteria
Ensure protocols in place to support work
Rochdale to nominate representatives to participate
Gail
Hague
Laura
Beesley
Laura
Beesley
Gail
Yes
Sept
Sept
Sept
Oct
13
in peer to peer support Hague
EY2.6
Stage 6
assessment in
place
Rochdale to nominate itself as a pilot for assessment
Through this develop components of assessment,
exposure compliancy issues, contract with providers
Consult on conditions to be attached to 2 year old
funding
Approval of conditions by Children and Young
people’s Partnership
Laura
Beesley
Laura
Beesley
Yes
yes
April
Aug
Oct
APM
EY2.7
Stages 1-5
assessment in
place
Agree implementation tools
Incorporate into local commissioning arrangements
Gail
Hague
Karen
Kenton
Nov
Nov
EY3
A GM early
years parental
contract linking
day care to
universal credit
EY3.1
Work stream governance arrangements agreed
Rochdale reporting mechanism from work streams in
place and key issues reported to Public service
Reform Board and Children’s and Young People’s
board
Laura
Beesley
Yes
April
EY3.2
Assertive
marketing of
free entitlement
complete
Draft agreement with parents consulted upon
Draft agreement approved
Bob
Adams
Laura
Beesley
Yes
Yes
Dec
Feb ‘14
EY3.3
Process agreed
for
identification of
family learning
and skills needs
at point of entry
to free
Consult, particularly with schools and childcare
providers upon the proposed model for supporting
parents on point of access
Process is signed off by key stakeholder groups
Process is implemented
Bob
Adams
Bob
Adams
Laura
Beesley
Yes
Sept
Nov
14
entitlement
EY3.4
EY Provider
Workforce
developed to
address
parental skills
in supporting
learning and
development
through the
home learning
environment
Establish baseline in Rochdale for level of provider
support for home learning as set out in Ofsted
Identify best practice and evidence based practice
Consider scaling up across all settings
Changes in contracts consulted upon and agreed
Gail
Hague
Laura
Beesley
Gail
Hague
Gail
Hague /
Bob
Adams
Yes
Yes
May
June
July
Aug
EY 4
Common terms
and conditions
for free
entitlement
funding
EY4.1
Common GM principles that will underpin individual
LA terms and conditions of EY Funding agreed
Consult upon GM principles and understand impact
on Rochdale of any EY
Sign off LA terms and conditions
Laura
Beesley
Yes
Feb’13
Aug
Sept
EY4.2
A common
approach to
securing quality
provision across
GM agreed,
implemented
and evaluated
Cross reference list of evidence based programmes
with those in use in Rochdale in order to establish
any risk factors
Action plan to minimise risks
Laura
Beesley
Laura
Beesley
Yes
Yes
July
July
EY4.3
A Common
approach to
accelerating and
tracking
children’s
learning and
Ensure the tracking system in Rochdale is fit for
purpose
Agree how to access impact
Ensure broad consultation on the withdrawal of
funding prior to inclusion in SLAs etc
Laura
Beesley
Laura
Beesley
Bob
Yes
Yes
July
Sept
Sept
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development
agreed and
implemented
Adams
EY4.4
Cross
referenced with
other day care
deliverables
Share as part of work stream Rochdale’s current
approach to withdrawal of funding
Risk assess any changes in this under GM model
Bob
Adams
Yes
July
Aug
EY5
A Shared
outcome
EY5.1
GM EY draft outcomes framework reviewed
Consult upon draft outcomes when available
Feedback to AGMA
Consider implications for funding, monitoring,
commissioning etc once list is defined.
Gail
Hague
Gail
Hague
Laura
Beesley
Yes
Yes
Yes
May
June
EY5.2
Investment
agreement
relevant
outcomes added
to the
Framework
Consult on investment agreement when prepared Laura
Beesley
Yes
EY5.3 GM EY shared outcomes Framework signed off.
Develop communications plan for shared outcomes
framework with all partners
Laura
Beesley
TBC
Yes June
EY6
A set of systems
that will enable
sharing of
intelligence and
information
Legal / statutory requirements and restrictions in
relation to EY data and information understanding
At this point unclear - writing brief
Laura
Beesley
Yes
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across partners
Current level of shared outcomes framework data
and information mapped
Awaiting clarification
Bob
Adams
Solutions (technical, legal, cultural) for sharing the
information and data specified in the Shared
Outcomes Framework developed
Laura
Beesley
GM EY Information Sharing Agreement signed off
Consultation on draft
Laura
Beesley
Jan’14
EY 7
A shared
performance
and evaluation
approach that
will underpin a
longitudinal
study of the
cohort over 25
years
Contribute to work stream group Gail
Hague
EY7.1 The
scope of the
evaluation of
GM Early
Years agreed
Consult partners on proposals present
recommendations to children and young peoples
group
Laura
Beesley
EY 7.2 To begin
capturing the
evidence of
impact to help
inform the
investment
agreement as a
flexible
agreement
April 2016 – later tasks to be sent
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EY8
Investment of
resources as set
out in the
investable
proposition
Core partners are commissioning bodies signed up to
‘in principal’ agreement
Consult ‘in principle’ agreement once produced.
Formal approval and signed off given
Laura
Beesley
Laura
Beesley
Yes
yes
June
July
NDM costs agreed and finalised
Consult with partners on proposed CBA method and
design.
Agreement by all partners on baseline and projecting
Laura
Beesley
July
Sept
Resource requirements agreed and implemented
Consider if Rochdale can offer resource to AGMA
team
Develop a new commissioning framework for GM
EY9
A common suite
of evidence
based
interventions
and statutory
services
decommissionin
g other
interventions no
longer required.
9.1
The list of statutory and evidenced based
interventions agreed
Communications and strategy for all partners
included.
Gail
Hague
To be
identifie
d
July
EY10
A GM-wide
commissioning
and
procurement
framework
EY10.1
To endorse the need to a EY GM commissioning
group
Rochdale to participate in group to ensure inform
process includes voluntary sector, local authority and
health
Gail
Hague
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EY10.2
Develop a new commissioning framework for GM
Consultation with all partners on interventions. Risk
analysis for impact of scaling up to GM
Karen
Kenton
EY11
GM-wide
workforce
agreement and
training
programme
Details not worked out.
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Health & Social Care
1. Summary
Overall l purpose
The primary objective is to work with partners to improve the citizens experience by delivering a substantial reduction in avoidable admissions to hospital
and other care institutions, mainly in the over 65 population. This means the development of “integrated care services” – care that is based around the
needs of people and carers that put them in control, that are joined up, and that deliver better outcomes for better value.
New Delivery Model
Common
components
Description Example services
Accessible &
Responsive
Care services will be easily accessible and responsive. Primary Care
and GPs should act as ‘first port of call’ particularly for people with
Long Term Conditions
Enhancing the range of services within primary care
Reducing variation in primary care
NHS 111
Improving Access
Providers
working
together
Health and social care teams will work an integrated way,
particularly for the frail elderly and people with Long Term
Conditions. Patients and their carers will experience care provided in
a seamless way with unnecessary duplication avoided as a result of
effective collaboration between those involved in the planning and
delivery of care.
Integrated case management across health and social care
Single assessment process, with elements of care co-ordination
across agencies
Working towards Community Neighbourhood Teams
LTC QIPP MDT meetings
End of Life Care Gold Standard Framework – meetings in primary
care.
Support for self-
care and
independence
Patients, individuals and their carers will be supported and
empowered to take ownership of their care and well-being so that
they are able to live independently and so that have health and
social care resources are targeted on the most vulnerable.
Patient education programmes
Expert patient programmes
Systematic use of direct payments, personal budgets
Carers strategy
Assistive Technology
Quick response
to urgent needs
There will be rapid access and response to urgent care needs to
minimise the reliance on A&E and to ensure that the most
appropriate care is provided.
Rapid Response/Intermediate Care teams, aligned to Reablement
Urgent Care centres
Joint urgent response services across health and social care on a
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24/7 basis
Planned
pathways of care
Agreed care pathways and protocols will be in place to ensure that
the patients receive standardised care with reduced variability and
unnecessary attendances.
Outpatient clinic redesign
Community clinics
Dementia Pathways
Transfer of Care
Appropriate
specialist and
hospital care
only when
required
Patients will receive appropriate specialist input in a timely manner
when required and will only spend the appropriate time in hospital
with planned discharge in the community as early as possible.
Early supported discharge service
Hospital at home teams, including Reablement
Integrated End of Life Care
2 Characteristics of New Delivery Models of integrated care
The local model will need to demonstrate that it has
a. Cross agency leadership commitment and governance including Local Authority (political and managerial) , CCG (clinical and managerial) and Acute
Trust (managerial and clinical) to new service models focused on substantially reducing avoidable admission to hospital and other care institution
b. An understanding of the costs and benefits across all partners of the new service models being proposed, and the contracting and reimbursement
models that would allow decommissioning and new commissioning to occur at a scale
c. A focus on scale – for example the need to target new interventions at cohorts of the risk stratified over 65 populations of not 1% or 5% but at least
20% and possibly more.
d. A focus on outcomes – to deploy analysis such as the AQUA/ADASS benchmarking tools to understand the baseline and test the effect of the
operation of the local system
e. A recognition of how interventions planned and delivered at a GM level (e.g. NWAS, 111, reconfiguration of some hospital services) will inform the
development of the local model.
f. A demonstration of the extent to which patient and carer experience is captured and used to inform future development of the model.
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g. A credible plan to address some key enabling functions, particularly
i. Data sharing agreements across partners that actually work at service level to support single entry and single access points for different
agencies
ii. Workforce development strategy that promotes genuinely integrated working, including joint training and development opportunities
iii. A “total place” consideration of estate utilisation to effect a the necessary shift of activity from hospital and care institution
4) New Contracting and Investment models
The analysis referred to in 3b above will demonstrate where the costs and benefits of a new delivery model will fall, across CCGs, Local Authorities, Acute
Trusts and others. Partners need to work together to develop contracting and reimbursement mechanisms that effect the shift to targeted and planned
interventions and away from the reactive spend associated with avoidable admissions.
5) Evaluation
New service models are likely to be introduced in pilot phase, but must be done so in a way that supports potential future scaling of the intervention to a
significantly larger part of the target cohort. As the outcomes are evaluated so the modelling assumptions in the cost benefit analysis can be replaced with
real data.
6) The localised agenda
The primary objective is to work with partners to improve the health and social care outcomes for our residents and the patient population of NHS HMR
CCG, and to develop a sustainable integrated system of health and social care for the future.
The particular strategic challenge is to redesign the health and social care system so that it offers people the best possible care in the best place, and moves
away from traditional pathways where these do not produce the best outcomes. All partners acknowledge that, unless we move to an integrated system,
which not only produces best outcomes but also makes best use of resources then the health and care system is at risk of serious failings as budget
reductions and efficiency requirements impact. From the outset savings plans for social care in Rochdale have been designed in partnership so that
unintended adverse effects across the system are minimised. Significant early progress has also been made in jointly commissioning new enablement and
related services that provide an alternative to hospital care.
The challenge for us all is now to plan to deliver a significantly changed system with large (at scale) shifts away from hospital care and to integrated primary,
community and social care in the community. For this to be achievable we need a wider range of options delivering primary, community and social care in
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the community which have the support of local clinicians, and local people. We need to invest in solutions that work including self-help and informal
support (family, friends, and communities). This challenge has been discussed at the CCG, the council cabinet, the HWBB and the Rochdale PSRB. As
referenced above increased joint commissioning of £3m has already been agreed for 13/14, and £1m has already been invested by HMR CCG in informal
family/friends community sector support. . We are currently re modelling 2 (previously local authority) residential care resources to become integrated out
of hospital care centres (one to focus on integrated dementia care), and also jointly commissioning individual complex packages of support. This is
considered to be early evidence of commitment to the integration agenda. We have also delivered important improvements in increasing End of Life care at
home, and in reducing residential care ; both in 12/13 and as a result of partnership working.
Health and Social care partnership working is steered in the borough through the Rochdale Borough Strategic Programme Board. This is chaired by Dr Chris
Duffy, chair of the CCG; members include other clinicians, Cllr Colin Lambert , senior officers from the CCG, provider partners and RMBC. Whilst the board
does not have decision making authority across partner organisations the level of representation on the board is designed to ensure that changes and
developments planned by the board have partner support and allocation of resources as required. The Strategic programme board feeds back to all partner
agencies, and through to the PSRB and the HWBB. The HWBB provides the ultimate leadership for the Health & Social Care integration agenda and the PSRB
the Borough wide cross theme offer.
We are clear that plans for system re design must be developed in collaboration with the main providers as partners, to ensure the new model is
appropriate and sustainable. Initially the board has focussed on a co-designed new model for Rochdale Infirmary, underpinned by a publically- signed
statement of strategic intent by all partners ,and associated with this is our development of community based services. We consider this to be a good
example of an emergent health and social care integrated system for our borough, although clearly it is early days and there is much to be done .
The strategic programme board is very aware of our responsibility to involve the public and wider stakeholders at the earliest opportunity when major
changes are being considered. The board will make use of the successful stakeholder assembly which has been established as part of the HWBB and
informs its work. The board is also currently developing an engagement and involvement plan which will ensure major proposed changes and
developments to the health and social care system are discussed at an early point with members of the public and other stakeholders
Local Model Checklist
The description below provides an overview of where we think we are up to in our partnership to redesign and integrate services in Rochdale.
Characteristic of successful local model Rochdale position /self assessment
Cross agency leadership commitment and governance including Local
Authority (political and managerial) , CCG (clinical and managerial) and
Acute Trust (managerial and clinical) to new service models focused on
We consider our leadership, as demonstrated through the Strategic
Programme Board, is appropriate to take on the task
We have early demonstrable progress
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substantially reducing avoidable admission to hospital and other care
institution
We are also currently refreshing and re focussing the work plan, and this will
take on the ‘at scale’re design challenge. We intend to agree models and
timescales for this in the next 2 months.
We are also commissioning some additional capacity to assist in this, and in
modelling what a fully integrated and jointly commissioned health and
social care system could look like – with a view to decision making in
autumn 2013
An understanding of the costs and benefits across all partners of the new
service models being proposed, and the contracting and reimbursement
models that would allow decommissioning and new commissioning to occur
at a scale
Currently this is included in specific areas of change, for example in the work
around the redesign of the new integrated care centres.
However we consider that we need to look beyond specific areas to cost out
the whole future system of health and social care based on optimum use of
resources available and development of models of care that will continue to
deliver patient outcomes, albeit in a different way to currently.
This is part of the commissioned work in the coming months
This also needs to link to local authority likely resources for social care going
forward
The CCG has a well established review process for commissioning and
decommissioning of services, and we are currently considering if this can
move to an integrated process that will include adult social care. This is, of
course linked to issues of governance and accountability and will be referred
to the HWBB and council cabinet for a steer.
A focus on scale – for example the need to target new interventions at
cohorts of the risk stratified over 65 populations of not 1% or 5% but at least
20% and possibly more.
This challenge will be played into our strategic planning in the coming
months
A focus on outcomes – to deploy analysis such as the AQUA/ADASS
benchmarking tools to understand the baseline and test the effect of the
operation of the local system
We are already using the AQUA/ADASS information which has recently been
discussed at CCG and at HWBB. Whilst useful it remains more about activity
than outcomes for people, and we would wish to develop this further. We
have committed to an integrated ‘whole system’ performance and
outcomes framework for the borough which we intend to develop in 13/14.
. The ultimate measure must be the outcome and experience of the patient
– and we are interested in developing the me statement approach to
understanding outcomes as being developed in social care
24
Recognition of how interventions planned and delivered at a GM level (e.g.
NWAS, 111, reconfiguration of some hospital services) will inform the
development of the local model.
As referred to earlier we absolutely understand the need to play in the
development of providers, and how best to commission provider services
across sector and GM level into the planning for the future. Our experience
of the work with Rochdale Infirmary shows that the system must manage
change, not any one part of it.
A demonstration of the extent to which patient and carer experience is
captured and used to inform future development of the model.
As noted above, we are developing proposals about how to understand
outcomes for individuals and how this informs change , as well as building
opportunities to listen to the views of the wider public and for these to
inform plans
A credible plan to address some key enabling functions, particularly
i. Data sharing agreements across partners that
actually work at service level to support single
entry and single access points for different
agencies
ii. Workforce development strategy that promotes
genuinely integrated working, including joint
training and development opportunities
iii. A “total place” consideration of estate utilisation to
effect a the necessary shift of activity from
hospital and care institution
This will be addressed in our next stage of development. We have various
examples of where this is taking place, for example our joint , successful
training on EOL, our new multi agency training on LTC , our consideration of
the use of hospital buildings and the links with the primary care and social
are estate that can provide opportunities for alternatives. However this will
need to be reviewed and expanded in line with future plans for re design
4) New Contracting and Investment models
As referred to above, it is relatively straightforward to understand costs and benefits of specific projects and our partnership working has already
demonstrated our willingness to move resources around the system.
However, as we all know cause and effect is often not straightforward and the alignment with investment and financial benefit has been a blocker to
integrated models in the past. This is the reason why we are considering a wholly integrated jointly commissioned system. This potentially removes the
need for agreements across partners re investment and benefit - with one acting as the lead commissioner. This is, of course, very ambitious but we are
increasingly of the view that this may present the most enabling way forward. There are considerable challenges for both the CCG and RMBC inherent in
this. As referred to above this is part of the reason for our decision to commission an options appraisal which will help us all understand the opportunities
and risks in various models, including a fully integrated jointly commission model.
25
The work with providers as partners at the Programme board should support us in achieving planned decommitments and investment on a sustainable
basis.
5) Evaluation
We have a regular monitoring and evaluation /service review process in place.
This will need further development as we understand and agree more significant changes.
What will success look like?
• Public satisfaction with their experience of health and social care rising year on year
• Mechanisms in place to measure user/patient experience as the most important and fundamental measure
• Positive public perception of the future model for Rochdale Infirmary
• Quality and dignity of care experienced by the public
• Reduced number of emergency admission and re admissions to hospital – with a range of alternative services in place
• An increased number of informal carers who are supported by health and social care in their role as carers and report better health
• Optimum lengths of stay when hospital care is needed (not necessarily the shortest)
• Safe and well coordinated discharge – minimal emergency readmissions
• Effective triaging ensuring people get to the right part of the system
• Consistency across the borough
• Year on year increase in the number of people supported to die in their place of choice
Who is leading this work in Rochdale?
The leads for Rochdale are Sheila Downey RMBC & Lesley Mort HMRCCG
The GM theme lead is Will Blandamer [NHS GM]
What are the milestones for implementation in Rochdale?
Timescales and milestones have not yet been agreed by the Strategic Programme Board. As noted above a refresh is currently underway and milestones
with timescales will be included in this. As this involves all partners it is essential that this is achieved through the programme board to assure partner sign
up and realistic deliverable timescales. The resulting plan will be performance managed through the strategic programme board.
Local Authority leaders have asked to receive an overview of the integrated care plans in development across GM in June 2013. A framework for this
submission will be created largely based on the characteristics identified in 2 above.
26
Action Number Health and Social Care Delivery Plan Lead Officer Part of
GM
Action
April
2013 –
June
2013
July
2013 –
Sept
2013
Oct
2013 –
Dec
2013
Jan
2014 –
March
2014
April
2014 –
Jun
2014
July
2014 –
Dec
2014
2015
HSC.1
Primary Care Reform
HSC 1.1
HSC 1.2
HSC 1.3
Reducing Variation across primary care
within the Borough
Improving Access
Responding to Patient feedback
April 2013 – March 2014
April 2013 – March 2014
April 2013 – March 2014
HSC.2
Transforming
Community Services
Horizontal and
vertical integration
including more co-
ordinated primary and
community services
HSC 2.1
HSC 2.2
HSC 2.3
HSC 2.4
Complete the rational and options for
Integrated H &S care Community
Neighbourhood Teams
LTC MDT QIPP
Stakeholder workshop and Engagement
Design and Implementation planning of the
new delivery model
April 2013-May 2013
April 2013 – Dec 2013
May -2013
June 2013-Dec 2013
HSC.3
Review and redesign
of Integrated
Intermediate Care
Services
HSC 3.1
HSC 3.2
Produce joint strategy, review and identify
recommendations for redesign with focus
on services based in patient homes to
maximise independence
Redesign of Tudor Court and Springhill
resources and integrate into Rochdale
Infirmary development
May – July 2013
June 2013
27
HSC.4
Development of
Integrated Dementia
Pathways
HSC 4.1
HSC 4.2
HSC 4.3
Establish Borough wide Local Area
Dementia centres including third sector
Complete Oasis Unit procurement with
fully integrated medical/mental health
beds with rapid access/discharge pathways
Complete procurement of Borough wide
GPSI posts to develop and strengthen
primary are Dementia services
July 2013-Dec 2013
July 2013-Dec 2013
July 2013-Dec 2013
HSC.5
Integrated
Commissioning
Infrastructure
HSC 5.1
HSC 5.2
HSC 5.3
HSC 5.4
PMO support allocated to deliver the
Integrated Commissioning framework
Ensure Governance processes within
Health and Social Care reporting structures
are in place
Development of a Joint Outcomes
Framework and associated metrics
Implement shared data systems to better
track customer outcomes across the health
and social care system
April 2013 – January 2014
28
Transforming Justice
Summary
Transforming Justice aims to reduce levels of crime, offending and reoffending across Greater Manchester by better, more coordinated support for
offenders at the points of arrest, sentence and release, and neighbourhood work to prevent offending. It has focused initially on youth and young people
(aged 16-25), because the peak age of offending is 19, and this age group accounts for 40% of criminal justice costs. And women offenders, due to the
whole system costs of female custody on families.
To generate sustained improvements in outcomes and reductions in spending, we need to think differently about moving resources around the system, and
the evidence base to support this. Rolling out new delivery models will not be sufficient.
New delivery models require reforms to:
• Youth triage – adopting a GM best practice model of coordinated support at the point of arrest
• Intensive Community Orders (ICO – previously called Intensive Alternatives to Custody) – scaling up and expanding an integrated support and control
package for 18-25 year olds at risk of short-term custodial sentences
• Resettlement support – integrated and coordinated support for offenders in custody to discourage reoffending and promote employment when they
are released (as being tested at Hindley)
• Women offenders – triage, intensive community orders and through the gate work
New investment models are required to scale up and sustain the new delivery models. Many of the benefits of reduced crime and offending fall to other
partners, for example:
• Youth triage – costs fall to GM Police and local authorities (YOS), benefits fall to Police, local authorities and courts
• ICO – costs incurred by Probation, benefits captured by MoJ/NOMS, GM Police, health, and HMT/DWP
• Resettlement support – costs previously fell to Youth Justice Board, benefits captured by Police, MoJ/NOMS, health and DWP/HMT
• Women offenders – costs primarily fall to Probation, civil society providers and local authorities, benefits captured by health, local authorities, Police,
MoJ/NOMS, Probation, DWP/HMT, and social landlords
The next stage is to turn the business cases into investable propositions which will support implementation of some NDMs in some districts prior to roll out
across GM.
29
Work streams include aligning future commissioning and decommissioning with the GM Police and Crime Commissioner’s priorities. Second, negotiations
with MoJ / NOMS about how GM can capture some of the benefits that flow from GM into national commissioning systems, including co-design of the
Transforming Rehabilitation proposals. The time-limited Financial Incentive Model payment of £2.6m will help scale up new delivery models, but will not be
sufficient in the medium term. Achieving this reward payment has shown that we can reduce demand in the criminal justice system.
Evaluation: TJ has strong evaluation evidence based on practical proof of concept tests in GM for Intensive Community Orders and resettlement support
(Hindley). Youth triage and women offenders do not currently have a strong evidential base, and the business cases are based on modelled assumptions.
Robust evidence about the impact of the delivery models on all partners’ key objectives will be required to generate full investable propositions.
Who is leading this work in Rochdale?
Mohammed Yunus, GM Probation Trust Rochdale & Oldham
Jeanette Staley RMBC
The GM theme leads are Richard Barnes [GM Probation Trust] and Alison Connelly [Office of the GM Police & Crime Commissioner]
What does success look like?
The GMS refresh proposes ambitious action on crime and justice. That GM will have reduced crime and reoffending in order to close the crime-rate gap
with the average of the most similar metropolitan police force areas from the current base of 2% above average. This represents reducing the total crime
rate of 789 per 10,000 population in 2011/12 to 774 in 2020. The Transforming Justice work stream will make a significant contribution to this headline
reduction, and will aim to ensure:
• A successful transition for 16-18 year olds from YOT to IAC
• That offenders comply with sentences from court
• Cohorts are moved into employment, education and training opportunities as part of their rehabilitation
• Have an appropriate place to live
• A reduction in severity of offending
• Active participation in the restorative justice approaches being developed.
• Victims are satisfied with outcomes
30
What are the milestones for implementation in Rochdale?
We are aiming to have an Intensive Alternative to Custody (IAC Plus) new service model established in the borough by October 2013. This is our main
priority following the business case presented and the cost benefit analysis undertaken. The IAC and YOT approaches will be closely aligned to ensure
supported transition for 16-18 year olds
We have already in place a Youth Triage based on the GM Model in place which we will continue to deliver as part of our reducing re-offending strategy.
It’s our intention to start work on the resettlement of offenders later towards the end of the year phasing the work according to our capacity to deliver.
We are conscious that we need to replicate the IAC approach for women offenders developing a tailored and bespoke model. This will be started once the
IAC model is in place and early evaluation helps to build the case and momentum for a similar approach for this target group.
Work on restorative justice and neighbourhood resolution will compliment these other activities and will strengthen the community input into our
approach.
31
Action
Number
Transforming
Justice local
delivery plan
Lead Officer
Pa
rt o
f G
M A
ctio
n?
Ap
ril
20
13
Ma
y 2
01
3
Jun
e 2
01
3
July
20
13
Au
g 2
01
3
Se
pt
20
13
Oct
-De
c 2
01
3
Jan
-Ma
r 2
01
4
Ap
ril-
Jun
20
14
July
-De
c 2
01
4
20
15
TJ1
Implement Intensive
Alternative to Custody
model in Rochdale
Borough
Mohammed
Yunus
1.1
Co-location of IAC with
Integrated Offender
Management (IOM) &
Stronger Families. All 3
services working from
the same location and
jointly delivering
services to clients
Mohammed
Yunus &
Jeanette
Staley &
Amanda
Jackson
1.2
Identify suitable
premises for
colocation of IAC, IOM
and Stronger Families
Mohammed
Yunus/Lea
Fothergill
1.3
Set up IAC steering
Group made up of
multi-agency partners.
Lea
fothergill
1.4 All partners on the
steering group to
complete
All
32
‘commitment’
template detailing
exactly what they will
be offering to the IAC
programme
1.5
Seek agreement from
Council to allocate one
full time equivalent
key worker to co-
located team, through
the ESF Families
Programme
Helen Chicot
1.6
Funding secured
through DWP flexible
support funding to
provide offenders with
employment related
support based on the
'individual placement
and support model'
Helen Chicot
1.7
Deliver Induction
Programme for the IAC
along the lines of our
Fire Fly Course
Tony Lander
1.8
Final Education,
employment and
training (ETE)
specification
completed, detailing
exactly what the ETE
Helen Chicot
33
offer is ready for
submission to courts
1.9
Clarify offer from
Police as part of IOM
move to be co-located
in same premises as
IAC and Stronger
Families
John Taylor
1.10
Recruitment of 1 full-
time drug and alcohol
outreach worker to
support those
offenders on an IAC
Tracy
Ginnever
1.11
Secure a worker to
deliver the Holding
Families model to a
cohort of young
parents who are part
of IAC.
Amanda
Jackson
1.12
Explore how we can
fund for the outreach
service e.g. monitor
curfew, transport
offenders to
appointments,
workplace, training
etc.
Mohammed
Yunus
1.13 Secure up to two
dedicated workers Mike Cross
34
from YOT(dependant
on the number of
young people 18 and
under in the cohort)
1.14
Develop links/services
with RBH and other
providers and clarify
offer for housing
support
Mohammed
Yunus
1.15
Liaise with CVS
regarding the potential
use of volunteers onto
IAC team. Clarify
connection trust 'offer'
to IAC
Mohammed
Yunus
1.16 Core team in place Mohammed
Yunus
1.17
Developing a cohesive
team (culture Training
Development etc.)
Mohammed
Yunus
1.18
Develop close working
with Forest Bank,
Lancaster Farms and
Buckley so that
offenders released
from prison are fully
prepared to go onto
IAC
Mohammed
Yunus
35
1.19 Build Business case for
investment agreement
Mohammed
Yunus
TJ2 Youth Triage Mike Cross
Yes
YOTs
and
GMP
are
develop
ing a
process
that is
consiste
nt
across
GM
TJ2.1
Triage assessments
delivered to Rochdale
and Bury custody
office to provide an
alternative to charge
and reduce FTEs
(process introduced in
April 2012)
Mike Cross
TJ2.2
Funding to be secured
through business case
to PCC from GM YOTS
Mike Cross
TJ2.3
Local provision to be
joint funded by
Rochdale and Bury
Mike Cross
TJ3 Develop and
Implement a
Restorative Justice
Strategy for the
borough
Jeanette
Staley
TJ4 Develop and
Implement a Pilot
Neighbourhood
Jeanette
Staley
36
Resolution
Programme for the
borough.
TJ5 Resettlement
TJ5.1 Developing ‘through
the gate’ services for
young adult offenders
Mohammed
Yunus
TJ5.2 Developing grass roots
resettlement options
for Buckley Hall
offenders
Linda Fisher
TJ6 Women Offenders
TJ6.1 Offer female only
environment for
women offenders
TJ6.2 Develop partnership
commitment to
women offenders
6.3 Develop relationships
with prisons.
6.4 Develop offer to
women’s services by
partners.
37
Troubled Families
Summary
The GM Troubled Families programme focuses on reducing the number of Troubled Families fitting the national TFU definition but also incorporates
upstream preventative work with families at risk of becoming troubled. This broader approach supports cohorts of families not yet in crises, and links to
other interventions (such as the Work Programme or programmes to reduce domestic violence) that support change around deep seated inter-generational
behaviours in order to achieve their goals.
Each family is unique, and is a primary influence on the behaviours of the people in the family. But currently, in the main, we deliver services without
seeking to understand or respond to this context, leading to huge waste.
• The new delivery model employs a single key-worker that ‘holds’ a family on behalf of all agencies. Public service systems need to be re-designed
so that this key-worker can ‘pull’ services towards a family in a sequenced manner at the time they will be most effective. This whole-family
delivery model is characterised by:
o strong multi-agency governance at case and programme levels
o key workers that are empowered to integrate, coordinate, prioritise and sequence support, informed by single, whole-family assessments
o creating bespoke interventions for whole families, supported by mainstream resources
o engaging the family in developing their action plans and identifying success – to promote self-reliance and responsibility;
o deploying high quality, common evidence and evaluation processes and tools, to show impact and allow comparison between different
delivery models in GM; and
o Using cost-benefit analysis to promote and inform joint investment that can sustain change
• The New Investment Model requires a range of partners to commit to sustaining the funding for the new whole-family delivery model once
national TFU funds cease in 2015. This will be based on local negotiations, informed by CBA and real evaluation data from local delivery models. It
is intended for all Districts to undertake this CBA over the summer of 2013, drawing on existing work, and to have Investment Agreements in place
by April 2014.
Work undertaken to date based on the most advanced exemplars across GM indicates the new delivery model will cost £138m to deliver but will
generate £224m in efficiencies across the public sector in GM and nationally, of which we estimate £110m is cashable.
38
• The Evaluation model for Troubled Families will be commonly used across all GM localities and partners. This will allow us to compare the impact
of different delivery models and to scale up what works. Local TF Co-ordinators have been involved in the development of the evaluation
framework and tools. Further evidence on the impact of locality delivery models will be gathered in line with this agreed evaluation model.
Who is leading the work?
Amanda Jackson is the Troubled Families Lead RMBC.
Steve Skelton Jane Forrest are the Troubled Families GM lead.
What does success look like?
• Reduction in the number of troubled families across GM
• Reduction in the number of families at risk of becoming troubled
• A significant increase in collective investment into early intervention and prevention services to families
• An agreed common approach to whole-family assessment adopted by all GM partners that addresses cross-border issues.
What are the milestones for implementation in Rochdale?
In order to turn round the lives of 675 families in the 3 year funding period, we will need to work differently. The approach presently being trialled aligns
with the GM NDM and builds on the proven intervention techniques of Family Intervention Projects including the following:
o An intense whole family approach, rather than dealing with family members individually.
o A single key worker assigned as the main point of delivery of services for each family.
o A key worker who is persistent, challenging and backed up by the use of appropriate and explicit incentives and sanctions, through the use of a
‘contract with consequences’ approach
o Different agencies and the family working together to a single sequenced plan, operating within agreed structures
o Sharing of information between services to ensure a full picture of the circumstances within a family and to develop understanding of potential trigger
points that may have caused some of the issues now of concern to services.
39
We are identifying in which services we are already using a key worker approach with families, and how we can refocus some of this resource. We have
designed the model to be a scaled approach to provide the right level of support for families, when it is needed. The model works with our ESF providers to
progress families towards work, and will soon have the benefit of a specific Jobcentre Plus Troubled Families Advisor, a significant role to support family
members into work.
Significant early milestones within this implementation are
• Appointment of 10 x Family Advocate roles to work with the most complex families – May
• Secondment of a Jobcentre Plus Troubled Families Advisor to increase focus on reducing worklessness, anticipated in May
• Development of heads of terms- June
• Interrogation of new TF database, when supplied with essential information feeds, to provide better insight into the Troubled Family cohort –
May/June
• Refresh and embedding of CAF, utilising ecaf as a whole family assessment – September
• Development of Investment Agreement December.
40
Action
Number
Troubled
Families local
delivery plan
Lead
Officer
Pa
rt o
f G
M A
ctio
n?
Ap
ril
20
13
Ma
y 2
01
3
Jun
e 2
01
3
July
20
13
Au
g 2
01
3
Se
pt
20
13
Oct
-De
c 2
01
3
Jan
-Ma
r 2
01
4
Ap
ril-
Jun
20
14
July
-De
c 2
01
4
20
15
TF
1.
Multi-agency
governance at
programme level
R
1.1
Accountability through
Early Help Strategy
Group to Children and
Young Peoples
partnership
Amanda
Jackson
1.2 Regular reporting to
PSR Board
Amanda
Jackson
TF
2
NDM
Key worker approach
R
2.1
Recruitment of family
Advocates (intensive
workers)
Amanda
Jackson
41
2.2
Through review and
revision of existing TYS
panels and key workers
to align work of
Targeted Youth Support
with Troubled Families
Dave Baker
/Amanda
Jackson
2.3 Implement revised
processes Dave Baker
2.4
Test Family Contract
(with consequences)
approach with families
Amanda
Jackson
2.5
Identify best approach
to maximise Work
Programme/Skills/ESFin
put, including new JC+
advisor for Troubled
Families
Amanda
Jackson /
JC+/ Helen
Chicot
TF
3
NDM
Data and information
R
3.3 Installation of bespoke
database for Troubled
Families cohort
Scott
Moseley
Recruitment of 2x data
role, 1 x Performance
role
A Turner
42
Refresh of annual data
sources
Scott
Moseley
Formalise and action
regular data feeds from
multi agency partners
Scott
Moseley
3.2 Customer insight
process to enable
targeted focus on
specific cohorts
Matt
France
Customer insight
process to highlight
potential claims
Matt
France R
TF
4
NDM
Common evidence and
evaluation processes
and tools
TBC
R
R/G
M
4.1 Review effectiveness of
family contract
Amanda
Jackson
4.2 Identify method of
demonstrating impact
and allowing
comparison between
delivery methods
Amanda
Jackson
43
TF
5
New Investment
Model
R
R/
GM
5.1 Cost benefit analysis –
identify dedicated
resource within
Rochdale
Julie
Murphy
Identify most
appropriate areas for
CBA in line with GM
model/approach
Amanda
Jackson
Undertake CBA
Julie
Murphy R
5.2 Using good practice
from other areas,
develop draft heads of
terms
Amanda
Jackson/
Julie
Murphy
R/
GM
Investment agreement
in place
R/
GM
TF
6
Preventative
work/Early Help
Refresh and embed CAF
and utilise ecaf as a
whole family
Laura
Beesley/
Karen
44
assessment Donnely R
Develop competencies
training to upskill
frontline workers
Amanda
Jackson/ J
Ainscow
45
Work and Skills
Summary
Greater Manchester’s drive to boost growth and increase productivity must be based on a skilled and motivated workforce. We therefore need
a high performing infra-structure for skills and employment services in Greater Manchester. To meet our aspirations the performance of our
‘supply-side’ infra-structure needs to both improve performance and increase efficiency.
Our challenge is to deliver more outcomes with less resource, which means improved targeting and co-ordination to make the most difference
for our economy and for our workless people. This requires a long-term approach, but we must start by working with current partners and
government programmes to align their activity and outcomes for our employers.
Our main challenges are to:
• Reduce numbers on the Employment Support Allowance (ESA) by reducing the inflow and increasing the outflow to jobs
• Improve qualifications and work opportunities for young people, particularly those not in employment or training
• Increase progression in the labour market for low skilled people, especially those who have repeated spells on Jobseekers Allowance
(JSA).
New delivery models require reforms to:
Reduce numbers on the Employment Support Allowance (ESA) by reducing the inflow and increasing the outflow to jobs
i. Fit for Work
• Greater Manchester ‘Fit for Work’ service - a universal service to all people at risk of claiming ESA or JSA because of health problems
that builds on a pilot
ii. Work Programme Plus
46
• Enhancing the Work Programme for ESA claimants: We want to work towards a co-designed Greater Manchester Work Programme
Plus for ESA claimants. We propose creating a GM Pathway to develop solutions and learning in co-operation with prime contractors. This will
use evidence bases and management information to develop future pathway solutions that add value. We will test different methods of
support including wage incentives for this cohort, co-case managed pathways and integrated services.
*In some areas this is about building on the troubled families’ models and ensuring work and skills is integrated within a family journey. *There
is also scope to test a new delivery model which sits outside Work Programme.
General Principles around a new way of working;
• Where appropriate, delivery to claimants within the context of their family, recognising that a more holistic whole family approach
is required if lasting sustainable change in attitude and behaviours is to be engrained in long term workless households
• Co-case management of families/claimants across organisational boundaries
• Better sequencing of interventions, recognising that significant resources already exist in the City but they are often poorly
sequenced and coordinating around the family context
• Integrating work and skills interventions with other targeted and specialist public service into packages bespoke to the needs and
context of the claimant/family
• The implementation of a family/claimant lead worker role, coordinating and sequencing interventions from across public services at
a neighbourhood level
• More effective coordinating of work and skills interventions, recognising the often unintended fragmented nature of welfare to
work and vocational skills provision
2. Improve qualifications and work opportunities for young people, particularly those not in employment or training
i. Traineeship
The BIS/DfE discussion paper, launched on the 9th
January, calls for input from providers, employers and key stakeholders to help shape the
national Traineeship offer. It is proposed that New Economy works with the Skills and Employment Partnership to develop a response from
Greater Manchester. This submission offers an opportunity to describe the GM approach and highlight what GM would need from
Government to maximise impact.
47
ii. Intensive Traineeship
Alongside the BIS-led development of Traineeships, DWP have been moving forward with plans to pilot a separate offer for young job seekers,
known as Intensive Traineeships. This would involve the provision of a 6-month intervention for 18-24 year old JSA claimants that have been
claiming for 3 months+, have no work history and have low skills. DWP are interested in piloting both a waged and non-waged option.
iii. Intermediate Labour Market (ILM)
Recent discussions with Work Programme Primes has indicated an appetite to deliver a joint offer that will bring together a number of funding
streams to create 6-month jobs for young people. Funds include:
• Work Programme Youth Contract Incentives
• Talent Match investment (GMCVO/Big Lottery) from Sep 2013
• AGMA investment from the GM Commitment
• Potential for DWP investment, recognising the link to a future Job Guarantee or similar for those that don’t progress from the Work
Programme
3. Increase progression in the labour market for low skilled people, especially those who have repeated spells on Jobseekers Allowance (JSA).
Building on the Universal Credit trial: We are exploring options within the planned UC trial in Pathfinder areas to pilot ways in which existing
services can be brought together in a more integrated way, not only to support the digital application and ‘work pays’ ethos of UC, but to
provide progression support and increasing learner demand for skills
*It should be stated that much of the work around work and skills is outside local control. Employment and skills delivery is largely by
autonomous organisations via national contracts.
New investment models
There is a recognition that some Local Authorities are investing in work and skills interventions. There is still a challenge as to how the
movement of money occurs around the system and what control Local Authorities and local partners have in terms of new investment models.
*Where Local Authorities are investing differently please could this be described?
48
Evaluation:
Our priority is to co design with DWP (and BIS as appropriate recognising that the intervention(s) cut across DWP and BIS worlds) an evaluation
and performance framework that will inform the Cost Benefit Analysis and the development of any Investment Agreements between partners.
In doing so, the purpose is to contribute to the national knowledge-base and support both Departments in roll out to other areas of the UK.
Similarly, there is a need to design the test and control groups to maximise learning at minimum incremental cost.
Who is leading this work in Rochdale?
The GM theme leads are Gemma Marsh (New Economy) and Andy Bowie.
The Rochdale theme leads are Susan Ayres and Helen Chicot.
What does success look like?
A target has been set to reduce the gap between the national claimant rate and the GM claimant rate by 1 percentage point. Based on
expected labour market performance this would equate to 36,000 fewer residents claiming an out of work benefit compared with the latest
2012 figure and 17,000 fewer claimants in 2020 than we would expect without any intervention.
The work and skills work stream will make a significant contribution to this headline reduction.
What are the milestones for implementation in Rochdale?
Rochdale Skills and Work Advisory Group reports to the Public Service Reform Board and has confirmed that it is keen to test the new delivery
models and that, in addition to the main delivery models, which can be implemented within the GM time frames, there are some additional /
complementary pieces of work that we would be keen to take forward as part of this agenda.
We have been developing / testing approaches to skills and worklessness which align with the GM principles and which incorporate other
areas; specifically, troubled families, health and early years. The evidence and impacts identified so far are positive, following work which has
been delivered under the ESF family support programme, skills improvement strategy and Community Champions project.
49
Our local delivery plan for the main GM delivery models will align with the GM approach and time frames.
We have outlined a delivery plan for the possible additional projects below.
RWS1 (Reduce inflow onto ESA): Work and Skills transition support for vulnerable young people. Using the family-centred approach to
support young people in transition from children’s to adult social care services. The work would be focused on equity of outcomes for young
people who have experienced difficulties in childhood which may lead to difficulties in adulthood relating to mental health issues, drug or
alcohol use, anti-social behaviour or other difficulties. Pilot work so far has focused on achieving skills and work outcomes, integrating
provision from children’s or adults social care services, child or adult protection, whole family support, specialist trauma support, whilst
focusing on the day to day priorities of the young person and their family, so that their plan makes sense and is achievable. The outcomes
from a small pilot have been very positive and it may be scalable to other young people such as care leavers.
RWS2 (Improve qualifications and work experience opportunities for young people): Local work to segment and understand how a
commitment to youth unemployment offer works for different groups of young people has revealed a gap in provision for young people with
learning difficulties and / or disabilities (LLDD). This gap is borne out when considering at the local offer from a Children’s Service perspective
(EFA provision for young people with LLDD up to the age of 35), resulting in a disproportionately high number of more costly out-of-borough
education placements and subsequent difficulties engaging young people into a local supported employment offer when they’re over 25 (and
funding is more limited). Rochdale Skills and Work Advisory Group have approved work on a business case for supported internships /
supported employment / jobs with training pathways for young people with LLDD.
RWS3 (Improve qualifications for young people): Rochdale’s work to improve skills levels in the borough is advancing at a pace, and a
particular piece of work, targeting young and adult parents of young children is having a positive impact, both in terms of the skill levels of the
parent and the home learning environment (having a positive impact on the literacy levels of the pre-school child). This piece of work is linked
with the recently completed NIACE BIS funded Lone Young Parents project (Rochdale was a pilot site) and the National Literacy Trust Literacy
Champions project, for which Rochdale has been a leading area for a number of years.
RWS4 (cuts across skills, worklessness, health, troubled families and early years workstreams): In Rochdale, we’ve developed a model of working
with community members in deprived areas to enable them to help each other and that has led to remarkable results. Rochdale’s Community Champions
50
project has seen over 450 volunteers from communities and neighbourhoods within the borough work in partnership with local services and providers to
deliver over 6000 attributable positive outcomes including employment, skills, income, family and health improvements; all with tangible cost benefits. The
project has had a positive impact and resulted in changes both for those helped by champions and for the champions themselves.
The project targets the local communities with the highest levels of deprivation in the borough and engages with people in the area who want to help
others. The volunteers are asked to identify their priorities and what they want to focus on and are provided with training, supervision and support to
enable them to develop and deliver their own solutions.
The project receives referrals for support from partner organisations such as Jobcentre Plus, local skills providers, children’s centres, community services,
GPs, psychological therapy services and schools. People who need help with specific issues (such as low literacy, unemployment or struggling mental
health) or general issues (such as poverty or low mood) are matched with a Community Champion. The outcomes are remarkable for both.
51
Action Number
Work
and Skills
local
delivery
plan
Lead Officer
Pa
rt o
f G
M A
ctio
n?
Ap
ril
20
13
Ma
y 2
01
3
Jun
e 2
01
3
July
20
13
Au
g 2
01
3
Se
pt
20
13
Oct
-De
c 2
01
3
Jan
-Ma
r 2
01
4
Ap
ril-
Jun
20
14
July
-De
c 2
01
4
20
15
RWS1
(Reduce
inflow to ESA
– transition
for
vulnerable
young
people):
RWS1.1
Evaluate
pilot, develop
model /
business case
Helen C
RWS1.2
Agreements
with
children’s
and adults
social care
service to
identify
volumes,
agree
investment
strategies
52
and
pathways.
RWS1.3
RWS1.4
Negotiate
contract
variations
(ESF family
support
programme)
(other
investments)
Helen Ct
Deliver Providers x
RWS2
Improve
qualifications
and work
experience
for young
people
(LLDD)
RWS2.1
Develop
business case
/ engage
parties
Helen C
RWS2.2
Pilot / review
/ revise /
negotiate
investments
Helen C
53
RWS2.3
RWS2.4
RWS2.5
RWS2.6
Clarify and
agree
contract
models and
social
enterprise
arrangements
(Learning
disability day
services)
RL
Revise and
implement
new LLDD VI
form
curriculum
Post 19 LLDD
curriculum
Redwood
school
STEPS
(Hopwood
Hall College)
Deliver
supported
public and
private sector
internships as
part of VI
form and
post 19
curriculum
LLDD
commissioner
HC
Deliver
supported
private sector
/ social
Learning
Disability
Day Services
54
enterprise
employment
pathways for
over 25s.
RWS3
Improve
qualifications
for young and
adult parents
RWS3.1
Review
findings of
action
learning set /
NIACE pilot,
develop new
business case
/ investment
model
HC
RWS3.2
Develop new
parent skills
pathway
through
Children’s
Centres with
childcare
£support
HC / DS
RWS3.3 Deliver
DS /
Providers
(supported
by the
Economic
55
Affairs team)
RWS4
Community
Champions
(skills and
worklessness,
health,
families, early
years)
RWS4.1
Revise
business case
/ delivery
model based
on 12-13
research
findings /
impact
reports
HC
RWS4.2
Deliver new
model –
impacts skills,
employment,
health,
financial
inclusion,
mental
health, family
and early
years.
HC
56
(Note all the above work streams interrelate and influence each other to varying degrees. We have avoided putting the same activity in a
number of theme delivery plans particularly around some of the enablers and cross cutting themes. These issues will be picked up through
a planned challenge process and will form part of the integrated work programme. )
57
System Reform
Summary
The successful transition and integration of public service within GM and at district level is dependent upon orchestrating a significant cultural
shift across a variety of public services.
Developing a range of effective and efficient activities (enablers) which smartly cut across the public service reform themes is essential to
support this shift.
Improving our systems, equipping our employees and having the flexibility around budgets to work differently need to be progressed
simultaneously to the development of the themes in order that we maximise the use of our resources and avoid unnecessary duplication this is
a considerable challenge.
Some of this work has been undertaken already and we can build on this. In some areas it has yet to start and we will take the opportunity to
learn from other councils and partnerships and develop good practice to inform our way forward. Actual dates for completion of activity will
be agreed over the next few weeks.
Who is leading this work in Rochdale Borough?
Linda Fisher Deputy Chief Executive will lead the work overall
Julian Massel will lead the integrating information & systems element
Funding and Investment will be led by Julie Murphy
Workforce Development will be led by Janet Ainscow
Assets (as in buildings) will be led by Helen Smith.
58
Action
Number
System reform
plan
Lead
Officer
Pa
rt o
f G
M
Act
ion
?
Ap
ril
20
13
Ma
y 2
01
3
Jun
e 2
01
3
July
20
13
Au
g 2
01
3
Se
pt
20
13
Oct
-De
c 2
01
3
Jan
-Ma
r 2
01
4
Ap
ril-
Jun
20
14
July
-De
c 2
01
4
20
15
SR1 Integrating Information
Yes
SR1.1
Establish robust data
management
information systems
incorporating and across
the PSR themes
JM
SR1.2
Further develop safe
information sharing
within a framework of
information sharing
protocols
JM
SR1.3
Map the overlapping
cohorts of theme
customers to ensure
targeted focus and
intervention
MF
SR1.4
Develop a new
Integrated Needs
Assessment to act as the
evidence base for joint
and individual
commissioning
TBC
SR2 Integrating funding
No
SR2.1 Develop Partnership
capacity and capability TBC
59
to undertake CBA &
Evaluation
SR2.2
Investigate and develop
a framework of common
partnership evaluation
standards.
JM/LF
SR2.3
Develop partnership
financing proposals
around each theme
Theme
Leads
SR2.4
Investigate the
appropriateness of
developing a protocol
for joint investment /
investment agreements
JM/LF
SR3 Integrating our people
Yes
SR3.1 Be clear about the level
& scope of GM WFD led
activity. Continue to
actively use the AGMA
Virtual College e
learning platform and
the Training and
Development
Framework.
JA
SR3.2 Develop and implement
other common WFD JA
60
tools with GM partners
SR3.3 Confirm funding
package in place JA
SR3.4 Identify best localised
WFD approach i.e. cross
cutting or thematic
JA/FN
SR3.5 Identify the local level
WFD issues and develop
an implementation plan
JA/FN
SR3.6 Procure training &
development across the
themes
JA/FN
SR4 Further Integrating our
Assets
Yes
SR4.1 Influence the developing
GM assets programme H S
SR5 Contribute to and
Influence the
development of a place-
based settlement for
GM
JT/CL
Yes
Time lines for the above activities will be confirmed by June