Today we are releasing a summary of our research findings into what drives poorer outcomes for patients and service users.
Last week we held the second of our ‘Early Help Learning’ sessions, bringing together a group of children’s services practitioners from six local authorities to discuss some of the most pressing issues around early help for children, young people and families. The first session, which you can read more about here, was a broad ranging discussion which highlighted the complexities inherent in delivering an effective early help offer. This new session was more focussed, in particular looking at models of delivery and the challenges of turning a theoretical approach into reality. It would be impossible to convey the four hours of rich discussion into a single post, so instead I want to focus on three of the key questions that emerged.
Question 1 – Design the perfect model, or just get going?
As my colleague Jon Ainger pointed out in his recent blog inefficient early help expenditure is a problem. Money is too often being spent on the wrong people at the wrong time. One response to this is to undertake a detailed needs analysis, review the existing services and complex commissioning processes and blend this analysis together to create a perfect model. Whilst these activities have value in their own right they do take time. Can families wait that long? Also, does the council have the spare capacity to do this? It became clear from our participating councils that they would rather get going as soon as possible and learn by doing. However, the challenge this poses is how big do you bet that your approach will work from the off.
Question 2 – Start small or start big?
Many attendees talked about using multi-agency meetings to discuss specific cases as a way of kick-starting their early help programmes. This makes sense – it provides an opportunity to test an approach whilst having an impact on lives, it does not need a huge commitment of resources and it can be scaled up. However, as one attendee noted from experience, it can create a perception that early help is focussed on fixing individual cases and does not have the strategic vision to identify emerging trends and reduce demand on a large scale. The lesson seems to be that getting people round the table to work on tangible outcomes is important, but it needs to be set as part of a wider programme of change.
Question 3 – Localities, council-wide services or both?
The final question is about how to organise your services. The consensus view was that locality work is the most effective approach. Workers can get to know their area, the people who live there and spot emerging trends or issues. However there are some risks; how do you ensure consistency across localities? How do you ensure specialisms aren’t diluted? How do you manage small specialist services that do not have the capacity to be in every area? The consensus was predictably a blend of locality based and centralised council wide services, however, attendees were consistent in that such a blend would need to reflect local circumstances. As is always the case, local authorities are very often similar, but never the same.
We’ll be holding more sessions like this over the course of the next year so if you’d like to learn more then drop me an email at firstname.lastname@example.org and I can send you further details.