Old and New Partnerships
Ann Skinner
CEO Resolving Chaos
Resolving Chaos – who we are
Resolving Chaos is a small not for profit, Community Interest Company.
• We are a ‘spin out’ from the Department of Health. Transition to independence
took 2 years, we have been independent since Oct 2012
• Our focus is to improve outcomes for people with multiple needs
• We work with and support commissioners and providers to create a business
case for investing or re-investing in services to help people with chaotic lives and
multiple problems improve their lives
• Our focus is that the cost of chaos results in high costs public services (A & E,
prison, arrests, mental health care) and that an economic case can be made for
systems change by commissioning the right support services
Our projects
Examples of our work are:
• We have led 14 NHS funded Social Inclusion pilots. Two thirds secured sustained
investment as a result of the investment case we made
• We have undertaken an investment review in LB Brent of Supporting People to
test the extent to which the SP Programme contributed to the Councils priorites –
to review and identify outcomes and effectiveness to maximise impact and
financial benefits to local communities
• Olympic boroughs project – to train individuals to use diagnostic tools – the chaos
index and Service outcome tools – to calculate cost of services use over 12
months
• Lead Partner for the Lambeth, Southwark and Lewisham BIG Lottery Fulfilling
Lives- Multiple and Complex needs programme
Partnership Working –moving with the times
Partnership and collaborative working is nothing new… but a necessity more than ever
before in a climate where there is less funding and higher expectations.
Staying ahead of the game – a lot to get your head around and new commissioning
arrangements and new people to get to know!
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Localism – moving away from Regional infra-structures
Clinical Commissioning Groups & GP Commissioning
Health & Wellbeing Boards – include Public Health Managers
Health and Social Care Integration – radical service transformation over next few years
Micro-commissioning - Personal budgets for a range of vulnerable groups
Macro Commissioning - Prime providers and sub-contracting - MOJ
Payment by Results – demonstating economic impact against outcomes
Opportunity or threat (or both) ?
Where do you fit and who you can work with in the market place to strengthen your
service offer ?
Our Lambeth Southwark and Lewisham Partnership BIG Lottery Programme for people with multiple needs
KEY REQUIREMENTS
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Cross sector partnership - led by the VCS but involving key statutory agencies,
commissioners and other providers
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Bring experience of working with people with multiple and complex needs across
homelessness, mental health, substance misuse, offending – mostly not
accessing sustainable services as not eligible or barred from the system
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Enable potential ‘beneficiaries/users’ to shape and design the project
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Include a small core partnership group of organisations which can add significant
value and which can make decisions quickly
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The core group and partnership may change and evolve as the project develops
Making the Case /Demonstrating Outcomes
Key Outcomes for the BIG Fulfilling Lives Programme are:
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People able to manage their lives better through access to more person centred
and coordinated services
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Services users empowered to fully take part in design and delivery
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Shared learning , outcome measurement and cost benefit analysis will
demonstrate the impact of service offer to key stakeholders and commissioners
Lead Agency
LSL Partnership
Core Group
VCS
Statutory agencies
LA’s NHS, Slam
Users and
Carers
Includes Core Group and
the development of a
wider partnership
CORE GROUP MEMBERS
The Core Group s key role is governance and programme management
It has a committed, close working membership who have a strong track record and
knowledge of working across the boroughs. It is made up of representatives from the
4 client groups, LSL commissioners and Slam.
Working with the Lead Agency Resolving Chaos on the group are;
• St Giles Trust – Evan Jones (Vol sector reference group lead)
• Thames Reach – Bill Tidnum (User involvement reference group)
• Certitude – Nicholas Campbell –Watts
• SLAM Addictions – Mick Collins
• LSL Commissioners – James Lee (Lambeth), Mike Hammond (Lewisham), Mark
Taylor ( Southwark), Tanya Barrow (Southwark)
The LSL Delivery Model
Aim: Focus on Systems change and influencing future investment.
Model includes;
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Target group – 270 people with entrenched and complex needs (approx 30+ per
borough)
A multi-skilled team to ‘fast track’ individuals into new and existing services using a
consistent trusted adult , including peer support
Individual budgets to give choice to a wide range of services
Outcomes and economic analysis through the journey of the individuals
Building of a business case for future investment
Economic evaluation with other areas – Brighton, Newcastle, and Camden & Islington
LSL Feasibility Study – cost of use of services over 2 years
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Identifying the 5 archetypes within borough
High costs, poor outcomes, known by lots of services
‘Super Tuesday’ Process identified 70 people (via health, housing , adult services, criminal justice)
across the three boroughs – Lewisham, Southwark, Lambeth
Comparative costs with the input of our intervention
Assumptions
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Marginal costs where possible
Locally agreed prices
Rent, medication and benefits not included
Estimate we have 60% of the service data
Outstanding crime and hospital information
Latrice 1 year – 2012/13 : £50,989
Probation referral, £800
Prison, £0
Case
conferences,
£900
Magistrates Court, 0
Arrest, £5,384
Police call-outs, £920
ASBO, £5,350
Housing Support, £18,000
Detox, £2,523
Housing Moves, £1,950
Social Worker, £2,523
Ambulance, £230
START team, £2,523
Psychiatrist, £6,408
In-patient mental
healthcare, £0
A+E, £173
GP, £792
Assessments, £1,313
Hospital Admissions, £0
Outpatients, £1,200
Net savings from a 10%
in costs over 2 years
Person
Cost before
intervention
Cost
after
Charmaine
£196,461
£176,815
Latrice
£115,471
Harry
Saving p.a.
per person
Proportion of
caseload
Numbers
£19,646
0.4
10
£196,461
£103,924
£11,547
0.2
5
£57,736
£128,306
£115,475
£12,831
0.2
5
£64,153
Tony
£145,746
£131,171
£14,575
0.12
3
£43,724
Mandy
£45,492
£40,943
£4,549
0.08
2
£9,098
TOTAL
CONFIDENTIAL DRAFT FOR
Savings
made
£371,171
Our Role and LSL Business Plan
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Lead agency - Partnership Agreement for Core Group in place – roles and
responsibilities
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Lead Evaluation mechanisms
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Lead Procurement mechanisms - for delivery
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Shared Learning with other Lead Areas
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Service user engagement mechanisms, including design of programme, eg: staff skills,
evaluation, measurement of success
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8 year Project and Resource Plan
Our Approach
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We are not a provider of commissioner – we have a neutral role to offer effective
solutions and work with both
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Our expertise is commissioning, economics …..and multiple needs
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Our focus is not on research or policy or complex academic models but on
supporting impactful delivery and better outcomes for our target group
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To develop a business case that demonstrates the impact of integrated service
design, provider development and partnership
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‘Speaking the language’ of commissioner and funders