The Council of the Future – innovating in community support
OPM Group Associate, David Newton, writes about innovations in community support on the Isle of Wight.
Last year I was fortunate enough to chair a committee to design an innovative and entirely integrated health and social care system on the Isle of Wight. It was a huge learning curve! At the core of our new model was something we called ‘shift to the left’. The idea that by freeing staff from traditional roles and boundaries we would enable them to work at the higher-end of their skill-set. Less skilful work would then ‘shift to the left’ to someone else who had stepped-up to the higher-end of their skill-set.
The approach seemed innovative but was also blindingly obvious. Numerous organizations have developed plans on this theme to make the most of diminishing resources. However, the passed buck must stop somewhere – and it does – with the people being cared for and the communities around them. They must also step-up. But how could this be achieved? How could we re-imagine community support? What we needed was more Innovation!
Dr Iain Lucas is the Chief Officer of Rowner Community Trust in Gosport. He’s worked in community development and regeneration in various guises for more than twenty years. He has seen a lot of ‘innovative’ new projects come and go; ‘Innovation can’t be top down.’ he sighs. He’s recently been trying to secure project start-up finance through health innovation funding. His project will provide community workers to help people find their way through the crumbling maze of health and social care support. Perhaps more importantly these workers will also help people create change; “the aim is to support individuals in real need to achieve personal action – it can’t just be signposting. We’ll employ people who recognize the need to listen to individuals and work with their wider circle to develop a community of support.” He remains optimistic despite having two deals thwarted at the eleventh hour by funding cuts and staff changes. He now sees a more local solution through GP practices as the key to establishing the service.
Despite his commitment to a community-based approach, he is wary of such models being paraded as a simple answer to the current crisis, “It can’t just happen overnight. I’ve been working on this for years”. He is adamant that while the model could work, the necessary community infrastructure isn’t there anymore, “You can’t just refer to the Voluntary Sector because there is so little of it left because it’s not funded any more”. So, more groups are needed but if organisations like his aren’t there to support these new smaller groups the effort to start-up and sustain activities can be too much for most people. “There’s a lot of myth-making going on” says Iain, “The idea that there are 100s of people waiting to spontaneously volunteer isn’t true. It’s hard to find volunteers, and when you do successfully recruit volunteers they need support and training. It all takes time and money. Someone has to pay for the core of an organization.”
“We still see lots of money being wasted by starting projects and then pulling out when the funding finishes.” laments Gill Kennett MBE. She has a long and distinguished career in community health on the Isle of Wight. Now, as a Parish Councilor in the town of Freshwater, she has spent the last three years developing the local community infrastructure she thinks will be essential to maintain effective health and social care support in this rural area. “We need to make projects sustainable by investing in the whole community. Town and Parish Councils are perfectly placed to provide that infrastructure.” However, she is also worried that agencies will assume this can be done without any support, “We can’t keep assuming everything can be done for free!”
When asked what helped her recent work the most Gill is torn, “We definitely did need the pump priming money – that made a real difference even though it wasn’t a lot – but getting access to the expertise in agencies is also hugely valuable – it doesn’t always have to be about money”. Indeed, many of Freshwater council’s project have been funded through parish level taxation – the Precept. In Freshwater, such proposals are talked through and finalized at a public meeting when priorities for the year ahead are being decided.
David Bartlett, a veteran of the regeneration world who retired to the Island is now Ventnor Town Council’s Town Clerk. He also feels the role of parishes could be critical and that the ability to talk things through with residents is key. “On the Island, it made sense to devolve some services to a parish level because parishes have total coverage and tax raising powers. To cover the cost of devolved services in our town we’ve more than doubled the Precept but we’ve done so with the support of the town.” To do this the council have invested time and money improving their communications and IT. Alongside regular newsletters and public meetings they also recruited more than 400 local people to play a more active role in decision-making through both physical and digital forums. Typically, these individuals are opinion formers in the town who then proceed to cascade debates and information informally through their networks. So successful has this work been that they are now being funded by health agencies to create a communication network with other parish councils to support community-based care integration. Crucially this network is about two-way communications to help form thinking and improve services as well as cascade information.
So, after communicating with thousands of people and working with the best part of a hundred organizations, what did I learn through our redesign? We quickly realized that you can’t ‘shift to the left’ until you have established community support networks. Good local support networks can help stabilize those at risk of a crisis and act as a safety net for those who have fallen between services. But this safety net is badly damaged and patchy – it needs to repair and grow. And as seeds need fertile land in which to grow, people need a healthy community infrastructure to grow support groups. So, while it is tempting to be distracted by innovative grand designs, it is the organic growth of formal and informal community infrastructure that urgently needs our attention. But we don’t need to re-imagine community support or fund big pilot projects. We need to work with and nurture what’s already there, so that organizations can develop their own community specific solutions – that would be truly innovative.
David Newton is an OPM Group associate and Senior Partner at Corporate Impact – an organisation specialising in improving public services through community engagement. He is currently chair of the Isle of Wight Whole Systems Integrated Redesign (WISR) Board. To find out more about OPM Group and our work with local government, local partnerships and communities, or to get in touch with David Newton, contact Rob Francis: email@example.com