Monday, September 19, 2016
Toolkit for Change – Canterbury District Council
In Canterbury District Council, Rob Francis, Richard Field and Sue Goss worked with the top fifty managers to develop commercial and entrepreneurial skills and inspire new ways of thinking that could lead to more creative service design.
What did we do
Drawing on research about best practice both in the local authority and elsewhere, we designed and ran three Toolkit for Change ‘challenge and creativity’ workshops – incorporating best practice from other councils, communities and the commercial world, framed clearly within the core values of public service.
Lenses for reviewing public service included channel shift, new forms of ownership and public service delivery, asset mapping and unlocking the capacity within local communities / partners, creative thinking and ways of valuing public impact and investment. In between workshop sessions, managers and staff worked on ideas, challenges and possibilities culminating in preparation and presentation of business cases for change to a panel in the final session.
Feedback on the process and benefits can be seen on this short video.
Monday, September 19, 2016
Health and social care integration in Kirklees
We have worked to develop collaborative leadership across health and social care systems in a number of localities. In Kirklees we were asked to support the creation of a integrated mental health commissioning system as an exemplar from which the whole system could learn.
What did we do
A very senior group of leaders worked together over a number of sessions to develop a shared set of principles and goal – and a series of practitioner workshops began to flesh out what this would mean for front line services. Recognising that success would depend on the strength of relationships between staff in different organisations, we designed and delivered a ‘Skills for Systems Leadership Programme’ for the public health, social care and CCG senior teams – agreeing key health outcomes and providing the skills and techniques that enabled cross-organisational teams to develop shared approaches to changing behaviour and tackling long-standing problems.
The programme built a strong network of organisations and individual leaders, a shared understanding of systems pressures and agreement about the way forward. The work included providing individual coaching and support to key leaders, facilitation and team coaching sessions for top managers and partnerships. The final stage of the programme was to create a dramatic ‘future scenario’ event for fifty or so participants including the voluntary and community sector, from which partner organisations developed a set of principles to guide future shared direction.
Monday, September 19, 2016
Repairing a dysfunctional partnership (client confidential)
We were asked to step in when relationships between a County Council and Clinical Commissioning Groups broke down. Trust was low, meetings were fractious and unproductive and progress in health and social care integration had halted.
What did we do
Sue Goss began a painstaking process of meeting each of the leaders individually, listening carefully to their feelings as well as their account of what was going wrong. After hearing from everyone, she brought a leadership group together and shared a ‘problem tree’ – a visual representation of all the emotions, concerns, problems and issues that had been aired – and gained agreement from everyone to try and change things. A carefully structured awayday followed, in which leaders worked in pairs to listen to each other and build an understanding of the different perceptions and assumptions that had grown up. These were then shared in small groups and finally in the whole leadership group.
Participants discovered that although they were often in rooms together, the pace and format of meetings and the size of agendas left little time to think and less time for meaningful conversations. The formal technical language of strategy and plans made it hard to express worries, and no-one felt their concerns were heard or responded to. What was striking was that this was a dysfunctional system with no “villains” – everyone was trying to do their best.
By creating space for the right conversations to take place, and the difficult work that had so far been avoided to be faced – it was possible to slowly build trust. Relationships slowly improved over a number of months – and while tensions didn’t go away, it was easier for them to be named, and dealt with. Leaders began to pick up the phone or go for coffee together, rather than sending prickly emails. This is work in progress.
Monday, September 19, 2016
Southend Vision for 2030 – Southend on Sea Borough Council
Following an initial phase of community and stakeholder engagement carried out by Southend-on-Sea Borough Council, the OPM Group was commissioned by the council to deliver a community engagement programme to support the Borough and Council in setting its community vision. The aim of the project was to facilitate a series of conversations to explore and develop the collective aspirations of a different groups within the community for the Borough, as well as identifying how these groups will work together to achieve it against a backdrop of reducing resources.
What did we do
In order to ensure that conversations were grounded in a detailed understanding and appreciation of the challenges and opportunities facing the borough, the initial stage of the project centred on in-depth research and scoping. This comprised community and stakeholder mapping, a rapid document review of recent public engagement and service monitoring data for the borough and a series of telephone scoping interviews.
The central element of our approach focused on a participation and engagement, harnessing the energy and enthusiasm of communities to ensure buy-in to the vision being developed. We carried out a series of workshops involving a wide cross-section of Southend’s communities, from businesses to grass-roots local organisations to residents more widely.
These events comprised a smaller, targeted focus-group style discussions with specific groups as well as larger open-invitation workshops and enable local people to contribute thoughts and ideas to the ‘narrative’ being developed so that it reflected a genuine community-wide, collaborative discussion.
Monday, September 19, 2016
Our evaluation finds end of life coordination centre a success
Our evaluation looking at the impact of a new End of Life Care Coordination Centre based at Royal Trinity Hospice has found that patients using this centre are less likely to be admitted to hospital or to die in hospital at the end of their lives.
The was designed to address confusion among patients and their families about who to contact for help and support, due to the range of organisations involved in caring for someone approaching the end of their life.
It comprises a 7 day nurse-led coordination team and helpline for patients, families and professionals based at Trinity; a dedicated St George’s End of Life Community Nurse; and a team of Marie Curie Health and Personal Care Assistants who can offer specialised hands-on care at home for people with any terminal illness. It was commissioned by Wandsworth CCG as a two year pilot in February 2015.
We found the centre resulted in avoided admissions and faster discharge from hospital, which could reduce deaths in hospital. The centre was also found to free up clinical time for local healthcare professionals. The evaluation calculated these benefits could amount to potential savings of almost £350,000 to the NHS in the first year of the pilot, although these have to be offset against the cost of delivering the model.
The evaluation also found the centre improved the quality of end of life care through patients and families feeling supported at home and feeling reassured that they will be looked after. The quality of care arranged and provided by the centre was also deemed to be improved.
Dallas Pounds, Chief Executive Officer at Trinity, said, “Most people want to be cared for at home at the end of their lives rather than spending their final days in hospital. We now have evidence to show that the Wandsworth End of Life Care Coordination Centre is helping this become a reality for more people.
We hope other hospices and healthcare providers are able to draw from this evaluation so more people can achieve their final wishes at the end of life.”
The final evaluation report can be found here.
Monday, August 15, 2016
Unlocking Local Capacity – four years on
Let’s start with the scene-setting – the introduction you hear at every local government conference you’ve been to for the last five years. Money is getting tighter and tighter. Demand is growing – particularly in areas like adult social care. Five years from now – short of some miraculous windfall – councils won’t be able to deliver many of the services they do at present, at least in the way they’re used to, and maybe not at all.
Next, you hear something about citizens and communities. Wherever we look for solutions – localism, behaviour change, channel shift, technology, better partnerships and so on – sooner or later relationships with communities crops up as crucial to making at least some of this work. That could mean getting better at co-designing services with citizens, as opposed to calling them out to dull consultation events every few years. At the other end of the spectrum, it could mean local organisations – or even just groups of residents – taking on a service or an aspect of a service that otherwise would no longer be sustained. Both of these activities are happening already, of course, in different places and according to different challenges.
This much we know – and have known it, talked about it and predicted work around it for over the last five years. But what we know less well is how far everyone’s got on in actually doing something about it. And that is what I want to find out.
So, if you work in a local authority, what is your organisation doing to build, nurture or unlock the capacity in your communities? How have you been trying to genuinely, deeply involve local people in redesigning services, or in helping them to change their lives/neighbourhoods for the better in ways that might not involve traditional council services at all? We asked these questions to 30 local authorities in 2011-12 when we researched our publication ‘Unlocking Local Capacity: why active citizens need active councils’. We made the case that empowering citizens didn’t just mean councils ‘getting out of the way’, but that on the contrary, it demanded that councils play a very direct, active role – just working in a different way than many had been used to.
Four years on, we want to revisit those same questions and take stock of what councils are doing or planning now. For some, the constant pressure on budgets and ever-increasing demand will have put innovation around community involvement firmly on the back-burner. For others, those same challenges have been a spur to action, driven by the ambition of certain members, senior managers, officers at the coalface or other local partners to try new things. Are we seeing real, tangible results, or is it all still a work in progress?
Over the next few months I’ll be holding a series of telephone interviews with strategy and policy leads in local authorities to hear about their successes, frustrations, ambitions and plans to build local capacity and move into new, dynamic and impactful collaborations with community partners. I would love to hear from people delivering different things across a range of local authorities across England to build up a picture of what’s happening and what works. So if you’d to add to the debate, please do get in touch.
Monday, August 15, 2016
Handle with care: a case study in using baseline and follow up surveys
The new orthodoxy
Baseline and follow up methodologies have become the new orthodoxy when assessing the impact of interventions on programme participants – particularly when evaluating programmes with children and young people. In a context where experimental approaches are rarely seen as workable or even ethical, collecting baseline and follow up data is increasingly the default option expected by funders and commissioners. They are also relatively cheap to deliver – which, in current times – is appealing.
The evaluator will typically convert a programme’s anticipated outcomes into a set of indicators, use these to form the basis of a survey, and then invite participants to complete the survey at the start and end of the programme. They then hope for the best, based on an assumption that the programme will see a positive shift against the indicators over the course of the intervention.
However, when the results come back there are not always neat improvements in the follow-up. This is where disappointment and panic can set in. A surface level analysis of the data might suggest that the programme has had no – or indeed had a negative – impact on participants. This is not good for busy practitioners who are juggling delivery with the pressure of proving the impact of their work, particularly when they rely on good outcomes for future funding!
Drawing on our recent experience of evaluating a range of complex social interventions, while baseline and follow-up approaches are not necessarily the wrong tool for the job the results need to be carefully interpreted and contextualised and – where possible – cross-checked against other strands of evidence. Only then can you begin to draw out some sensible conclusions about the impact that might have been achieved.
A case study: evaluating Body & Soul Beyond Boundaries programme
We recently conducted an impact evaluation of Beyond Boundaries, an innovative peer mentoring programme for HIV charity Body & Soul. This used a baseline and follow up survey against key indicators. When the results came in there was a positive progression against the majority of the indicators. Young people who had been on the programme were more likely to communicate openly and honestly about their health and their HIV status by the end of the programme. However respondents responded less positively to some wellbeing indicators around self-respect and general state of happiness.
It would have been easy to assume that the programme had had little impact on these areas of wellbeing. However, further scrutinising of the different strands of data allowed us to develop an alternative analysis.
1) Beyond Boundaries did not operate in isolation from other factors that influenced participants’ lives. Programme staff emphasised that the particular cohort they are working with led very chaotic lives and tend to experience a myriad of socioeconomic issues. Here it could be reasonably argued that their participation in the programme may have been helping them to maintain a certain level of wellbeing, and possibly even prevented a more severe decline against these indicators.
2) As a consequence of receiving support and building trust with the service, there are examples where participants increased their emotional literacy and become more willing and able to answer openly and honestly about how they feel. This could explain how they became more able to appraise their personal sense of wellbeing in a more critical way. This finding is consistent with wider evidence that suggests that young people in particular are likely to overstate their levels of wellbeing at baseline and then provide more open and critical score in the follow up.
A further challenge was that, for a whole host of reasons, there was a high rate of attrition between participants completing the baseline and the follow up. This meant that the survey data in isolation did not produce a robust understanding of the impact of the programme. However, when this data was taken in combination with other strands of the evaluation it was possible to make stronger claims about the impact. Triangulating the findings from the baseline and follow up survey with case study and focus group data also allowed us to better understand participant’s journeys and to explore the impact of the programme on the most vulnerable and hard to reach participants, who are often the least willing to take part in evaluation activities.
Focus on why and how, not before and after
Collecting detailed qualitative feedback from programme staff and participants helped us to explore those crucial “why?” and the “how?” questions which helped to shed light on the pathways to outcomes. This was crucial when exploring the impact of a complex service used by participants who have equally complex lives.
Tuesday, August 9, 2016
Introducing our new blog series – engaging children and young people in research and evaluation
At OPM we jump at the opportunity to work on projects involving children and young people. Not only are they tremendously fun to work with, but we passionately believe in the importance of their voices being heard in issues that affect them.
From researching young people’s views on police stop and search powers to evaluating their experiences of major government policies like the SEN and disability pathfinders, I have been privileged to meet some amazing and inspiring young people in the course of my work here. And we are constantly developing our practice in this area to make sure our research combines meaningful participation by young people, with compelling evidence generated for our clients.
OPM Group colleagues have written a series of thoughtful blogs on this topic. First we have two linked pieces on challenges around measuring impact – both highlighting examples of our recent work with young people, but with plenty of relevance for research with adults too.
Tim Vanson’s blog draws on a recent impact evaluation of an innovative peer mentoring programme for HIV charity Body & Soul to explore the current emphasis on baseline and follow up methodologies, and the challenges of using surveys in this way to demonstrate impact. When surveys don’t show the results you might expect, how do you make sense of this and present the findings so that they actually tell us something meaningful?
Caitilin McMillan and Bethan Peach focus on soft skills, which many programmes and interventions aim to improve, particularly those involving children and young people. And many succeed in doing so, but it’s notoriously hard to prove this with any accuracy or consistency. In OPM’s evaluation of the GLA’s Stepping Stones programme, we are taking a fresh approach to this using the ‘virtual young Londoner’ tool. Read about how this enables participants to speak more openly about their aspirations, behaviour and attitudes, without feeling overly vulnerable or exposed – especially when speaking in peer groups.
Finally, Bethan Peach shares her 7 top tips for conducting qualitative research with children and young people, based on her recent experiences during a project for Essex County Council evaluating the impact of early help for families, children and young people. A sneak peek: don’t assume you know what’s going to work with any given group of young people, because they’ll probably surprise you. So be prepared for anything to happen, and enjoy when it does!
If you’d like to get in touch to discuss any of this work, or the other research we have done with children and young people, then drop me an email.
Tuesday, August 9, 2016
Our work with children and young people is informing best practice
We are delighted that our evaluation of the vInspired 24/24 programme has been included in the systematic review of the Early Intervention Foundation (EIF) Social and Emotional Learning Programme Assessment, contributing to the evidence base of best practice in this area.
The EIF has been funded by the Joseph Rowntree Foundation to undertake a programme of work to understand what works in developing the relational, social and emotional capabilities and assets of children and families either in or at risk of poverty. This work builds upon and extends an existing review carried out by EIF in 2015: ‘Social and Emotional Learning: Skills for life and work’
The 24/24 programme, managed by vInspired and funded by the Department of Education (DfE) and the Jack Petchey Foundation, was a structured volunteering and social action intervention programme, designed to help young people facing challenging circumstances to improve their life choices. The evaluation was designed to measure the progress of individuals during the programme and evidence the impact of the programme on young peoples’ outcomes and against key performance indicators. It also identified the critical success factors and limitations of the delivery model and made recommendations for future delivery.
The evaluation report can be accessed here.
Wednesday, July 27, 2016
New report on Motor Neurone Disease models of care
The Motor Neurone Disease Association (MND Association) has published our report exploring the different ways MND care is organised across the UK. It examines the practical arrangement of MND care, such as how multi-disciplinary teams are constituted and the relationship between hospital and community services. The report provides advice for the NHS and social services on how to organise MND care effectively.