Tuesday 22 September 2015

Seminar discussing First Contact Schemes & community assets


I wrote the following for our health & social care research website. For my blog, I'd like to make a couple of additional points:

Community Assets - really interesting how this plays out. I guess big question is how local agenda is shaped or dominated by larger third sector organisations.

Who should be targeted? Care Act 3 categories defined by Prevent, Reduce, Delay - nice model. But does this gloss over complexity. i.e. for 'single' LTC this may be appropriate, for multi-morbidity, or disability, it may be that a health or social need becomes acute that is not (directly) connected to the main LTC/disability - i.e. just because someone is in receipt of 'reduce' services doesn't mean that they don't also need 'delay' services, but this need might be missed if the person is categorised as a 'reduce' or 'prevent' category - I guess concern is that ppl are being put in boxes. rather than person-centred or comprehensive.

Re-blogged from 'Frail Older People Knowledge Hub'

http://emfop.org.uk/blog/health-maintenance/2014/july/seminar-discussing-first-contact-schemes

I attended this seminar on 30th June 2014 organised by Age Action Alliance (AAA) and Elderly Accommodation Council (EAC), hosted by AgeUK in London. It was great to meet with a range of stakeholders including representatives of First Contact schemes across England.
The meeting followed publication of a second edition of a report into progress of First Contact Schemes, by AAA & EAC. First Contact schemes were described as ‘practical ways to ensure older people can lead healthy independent lives’. These often include multi-agency referral (or signposting) pathways, coordinated by a ‘single point of contact’.
Michael Rodden (EAC) and Simon Wilkinson (AAA Department for Work & Pensions) jointly chaired the meeting and did a great job of introducing people and facilitating group discussions – with lots of flipchart capturing of discussion (see pics on twitter!)
During the seminar we discussed the role of the various schemes; differences and similarities. In particular issues such as partnerships involved, evaluation and funding. Many programmes hoped to be part of Better Care Programmes (led by Health and Wellbeing Boards). See flipchart schematic of Dorset SAIL
Coming from a health research perspective, it was great to hear more from the local government perspective. It was fascinating to discuss how these schemes may help to meet the aims and ambitions of the new Care Act. This places a new duty of improving wellbeing within all local government policy and activity. Helping people to stay healthy and independent is discussed within the consultation document (currently open for responses) as:
  • Prevention
  • Reduction of need
  • Delay of need
Groups discussed how various aspects of First Contact schemes could contribute to these 3 approaches.
Of particular interest for our research in CLAHRC-EM was discussion of standardised assessment of needs. This was seen as a benefit to demonstrate reach of programmes, but also was a challenge to deliver within a multi-agency collaboration. Challenges included both strategic agreement and operational delivery (completion rates). Although sharing data was acknowledged, particularly by Evan Morris (Chief Fire Officers’ Association) this was not discussed in terms of commissioning or Joint Strategic Needs Assessments (or Wellbeing Strategies). There was also interest in developing wellbeing indicators, which may be brief but pragmatic, especially for audit purposes.

On the way home I was pondering three questions:

Could data sharing bring more benefit than risk? Does the benefit of reaching people who may otherwise slip through the net, or the benefit of avoiding duplication, outweigh the privacy and security risks of data sharing. This is particularly salient in the context of the care.data (#caredata) debate.
How to demonstrate added value? If much of referral is about one agency increasing their reach to people who happen to be in contact with another agency – can we demonstrate increased referral rate, increased reach – and hence helping agencies to meet their mission aims? Maybe these are sufficient outputs of First Contact, rather the ambitious aims of showing health or social outcomes for individuals?
How do First Contact schemes relate and interact with Integrated Care programmes, locally? This was briefly mentioned, but it would be interesting to explore how First Contact may identify people with needs that are not identified by risk stratification tools, for example.

See some of the debate from the day by searching on twitter for @ageactalliance @age_uk @endloneliness

A week after the seminar, it was great to see Sue Warr from Dorset SAIL programme featured on the BBC national news!

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