Saving the human race – delivering
health and care beyond the walls
Introductions and aims of the
session – Chair, Elaine Meade
• Understand key success factors from
early years improvement work
• Understand how Asset Based
Community Development can help
focus improvement work
• Explore techniques for engaging
communities and families in the
improvement work
Judith Ainsley
Ambition
To make Scotland the best place in the world
to grow up in by improving outcomes, and
reducing inequalities, for all babies, children,
mothers, fathers and families across Scotland
to ensure that all children have the best start in
life and are ready to succeed
Our context
Community Planning Partnerships
- Partners work together to achieve
positive outcomes for citizens (5m)
Multi agency approach
Children from 0-8
Health inequalities
Social inequality
170,000 children live in poverty
Early Years experience has a
substantial impact on outcomes
The Early Years Collaborative
been building will & generating ideas for a while!
Brain
development
Perry
PreSchool
Ed
(2004)
GIRFEC
(2004)
CMO
report
(2007)
Early
Years
Framework
(2008)
Early
Intervention
(Allen
2010)
Knowing is not enough; we must apply
Goethe
Joining
the Dots
(2011)
Collaborative
(2012)
Early Years Collaborative
-9
months
to 1 year
1 year
to 30
months
30
months
to
Primary
school
5–8
years
Leadership
Scotland –
the best
place in the
world to
grow up
Stretch Aims
1. Positive pregnancies which result in the birth of more healthy
babies by end 2015, through a reduction of 15% in the rates
of stillbirths and infant mortality.
2. 85% of all children reached all of the expected developmental
milestones at the time of the child’s 27‐30 month child health
review, by end‐2016
3. 90% of all children reached all of the expected developmental
milestones at the time the child starts primary school, by
end‐2017
4. 90% of all children in each Community Planning Partnership
area will have reached all of the expected developmental
milestones and learning outcomes by the end of Primary 4, by
end-2021
The story so far
• Year 1 practitioners chose tests of change
and became familiar with the method
• Year 2 we identified key changes
• Now have 40 Pioneer Sites
• Faster learning for scale and spread
• 4 Learning Sessions
• Learning Session 5 on 9 and 10 June
Importance of using our Assets
• Massive change across the public
sector
• Scarcity of economic resources
• Health and Social Care Integration
• Children and Young People’s Act
• Lots of improvement activity
• All working to improve things for the
same children and families
Economic resources
diminish with use
• money
• materials
• technology
Natural resources
grow with use
• relationships
• commitment
• community
Adapted from Albert Hirschman, Against Parsimony
& @helenbevan
• 1140 -1145
• 1410 -1415
Video
• ABCD in the Early Years Collaborative
• 1145-1200
• 1415-1430
Angela Glassford – Head Teacher
• ABCD – Assets Based Community development
• Shared understanding of asset based work - what this looks
like in your context (values and approach)
• What did we set out to achieve and why? What was the plan and
how things happened?
• Sharing some of the specific ways in which we engaged with
children and their families to develop both individual and
community assets (our change ideas)
• How this enabled us to deliver better health and wellbeing
outcomes and experiences for the children in our locality
• How this fitted with our local priorities? The infrastructure to
support it.
• How we plan to spread and sustain this approach as we
move forward
Early Years Strategy
• Recognised need to focus
on early years
• Multiagency responses
• Workshops to develop
model
• Culture Change
• Family Focussed Approach
• £6.8 Million investment
Delivering!
Salutogenesis
Growing health
and wellbeing
Locality Model
•
•
•
•
Ferguslie and Linwood (Pathfinder Areas)
Core Teams in each locality
Mapping of existing community assets
Strengthening of links between existing services, including
third sector
• Integrated practice across the disciplines
• Building universal services and increasing community
capacity
• Targeting support in partnership with families
What do families tell us?
Someone to listen
to me…not
numerous people I
have to tell the
same thing to
again and again
Contact with
others so I don’t
feel alone
More support with
mental health
Someone to look at
my whole family
and not just judge
me
Someone to tell
me when I’m
doing well…this
really worked!
Someone to help
me see what my
problems are and
with support, how I
can solve them
More time with
someone helping
me
Core Team Structure
Locality Manager
Family Core Team
Co-ordinator
Family Wellbeing
Worker
(across both areas)
3 Family
Keyworkers
Admin Worker
Evaluation criteria
•
•
•
•
•
•
•
•
Family centred
Responsive early intervention
Integrated working
Flexible delivery of services
Adding value
Minimising barriers
Scalable
Measured against shared goal setting
Giving Our Children the Best Start
in Life –
A Strategy for the Early Years in
Renfrewshire
John Trainer
Angela Glassford
Sustain and Spread
• “It’s not what you do it’s the way that you do it.....”
• Link back to families as the driver of change and
development
• Outreach
• Organisational change
• Convert and enable
• Security of funding commitment
• Political will
• 1200-1215
• 1430-1445
Driver Diagrams
Knowledge for Improvement
Appreciation
of a system
Subject matter
Knowledge
Theory of
Knowledge
Understanding
Variation
Psychology
Knowledge for
Improvement
Appreciation
of a System
Where in the System of
Profound Knowledge are
we learning?
Theory of
Knowledge
Psychology
Understanding
Variation
What is a theory?
• A description of our best understanding about why
things are the way they are
• Theories/beliefs in other contexts?
•
•
•
•
•
Economics – game theory
Biology - theory of evolution
Physics – string theory
Metereology – chaos theory
Assets Based Community Development…?
How is a theory different from a belief?
• A theory can be tested scientifically
• Theories are predictions of the outcome of future
events
• Theory is the starting place for generating new
knowledge
Project Driver Diagram
plan
do
act
study
What do we believe about why
things are the way they are?
• Evidence – what objective evidence have we collected
locally or is available to us through the relevant
literature?
• Local subject matter experts – people who work at the
frontline who experience the system day to day and
have strong experiential beliefs about where change is
needed
Some guidance on creating a driver diagram
• Start with the outcome in mind – develop an aim
statement that reflects the desired future state
• Primary drivers should be nouns that reflect the key
leverage points in the system of interest from three areas:
1. Structures – physical, financial, administrative, management
and improvement, delegation and accountability
2. Processes – workflow of the system, how things are
accomplished
3. Operating norms – written and unwritten rules that govern
behaviour
Some guidance on creating a driver diagram
• Secondary drivers must be tangible things where action
can be taken on the system
• Change ideas should link directly to secondary drivers and
should exhibit these characteristics:
1. Specific - each change idea needs to be clear and concise and
it must be obvious how its introduction is different from the
status quo
2. How to - each change idea must include a statement about
how and where it will be put into practice within the system
• 1215-1220
• 1445-1450
So can we use this approach today?
Table time to develop your own aim – 5 minutes
• 1225-1240
• 1455-1510
TRIZ
Change ideas - using Triz as a mechanism to get the
elephant in the room and the change ideas on the table!
How could we STOP Assets Based
Community Development?
5 minutes table work to get ideas – be as
radical as you can be!
Make a list of all you can do to make sure
that you achieve the worst result imaginable
with respect to ABCD
From your list – cross out everything
ABSOLUTELY not possible
5 minutes
Go down this list item by item and ask yourselves,:
• Is there anything that we are currently doing that in any way, shape, or
form resembles this item?
• Be brutally honest to make a second list of all your counterproductive
activities/programmes/procedures
So what are you left with?
5 minutes – feedback
Go through the items on your second list and decide what
first steps will help you stop what you know creates
undesirable results
• Are these your secondary drivers or change theories to
work on?
Group your change ideas at your
table
feedback
Now populate the Driver Diagram
What will be different at the level of:
1
5
25
125
625
????
• 1240-1245
• 1510-1515
SUMMARY
• Next steps
• What are you going to do by next Tuesday?