ConneCted Care - Turning Point

Connected Care
Doing things differently
YOUR CONNECTED CARE CONTACTS:
Richard Kramer
Director, Connected Care
richard.kramer@turning-point.co.uk
Gemma Bruce
Development Manager, Connected Care
gemma.bruce@turning-point.co.uk

Co-production
Blueprint
Turning Point is one of the UK’s leading health
and social care organisations. We’ve been
running public services in communities across
the country for almost 50 years. Our Connected
Care model offers a way of working that
enables commissioners to engage with their
local communities, and use the insight gained to
develop better services, jointly with them.
What’s your challenge?
• Understanding the needs of the community?
• Integrating health and social care?
• Supporting patients with a long term
condition to better self manage?
We think it is time for this kind of co-production
to become the rule and not the exception.
• Moving patients out of hospital into the
community?
Engaging successfully with local populations
becomes more important every day. The changing
public health landscape means new bodies with
new responsibilities. The idea of “community
engagement” matters in this new landscape even
more than ever. For instance, the requirement
placed upon Clinical Commissioning Groups
(CCGs) is to put ideas of co-production of services
and community engagement at the heart of
their work. We all aspire to better public services.
Turning Point’s Connected Care model is a proven
and evidence-based method for improving service
design. And that inevitably leads to better services
too.
Where in the changing landscape are
you?
Would some signposting from an
established partner help you?
“I want co-production between
commissioners and communities in
health and social care to become the
rule and not the exception. If this is
realised then it could have a profound
impact on people’s lives by improving
the way services are delivered. I believe
our Connected Care model is the vehicle
to enable sustainable co-production.”
Lord Victor Adebowale
Chief Executive Turning Point
Connected Care is Turning Point’s unique
methodology for bringing about changes in the
design and delivery of health, housing and social
care services. This is about finding efficiencies in
the system – crucial when budgets are so tight.
We’ll help you rethink the way services work
together to support a combination of needs, and
look for ways to form an equal partnership with
communities in the design and delivery of public
services.
Connected Care is a bespoke service. We’ll
work with local commissioners to help define
the problem, and provide tailor-made solutions.
But there are four stages that are central to
understanding the method:
1. A community-led needs assessment
is conducted by trained community
representatives. These Community Researchers
drive engagement in every section of the local
community through rigorous research.
When we describe our intervention as “bespoke”,
what do we mean? Some examples might help
you see how applicable the Connected Care
blueprint is to your local area. In Warrington we
focused on neighbourhoods experiencing high
levels of health inequalities, helping to inform the
Council’s planning and improving engagement
with the town’s most vulnerable residents. In
the Gorleston area of Great Yarmouth we found
solutions that helped to reduce emergency
inpatient admissions. In Hammersmith and Fulham
we launched a Community Champions scheme,
providing community-based support across a
wide range of services. The initiatives may be
different but the method and outcome is the
same: services produced in partnership are
services that deliver.
Let’s talk.
2. This research leads to recommendations
based on a strict cost benefit analysis. These
are reviewed by a local steering group made
up of local authority, NHS, third sector and
community representatives.
Turning Point’s Connected Care model works with commissioners and
communities to co-design health and social care services. Since 2004, the
Connected Care team have delivered community engagement and service
design and set up new services - commissioned by local authorities, the NHS
and most recently CCGs - across the country
3. Service redesign or reconfiguration delivers
new levels of efficiency – focusing on service
integration and meeting the needs of service
users and commissioners alike.
4. Set-up of new services co-produced by the
community.
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Voice of the community
Meeting your agenda
Connected Care offers a flexible yet robust
model for service development and delivery.
Connected Care does things differently: it
accepts that a “top down” model of service
development doesn’t meet individual needs,
and that some existing care provision is in fact
very “disconnected” with individuals that need
our support falling down between the gaps of
disjointed systems and services.
Connected Care isn’t the solution to every commissioning problem. But it does
solve many of the common headaches that commissioners face. Here are a few
of them.
Changing landscape
biggest concerns right from the start.
Instead, the Connected Care methodology
fundamentally shifts the balance of power
towards local people, allowing communities a key
role in designing joined-up health and wellbeing
services that meet those local needs. And by doing
so, Connected Care drives delivery of improved
outcomes.
“Connected Care is a model for
commissioning that puts the voice and
needs of the community to the fore.”
‘A Vision for Adult Social Care’
Department of Health, 2010
A new way of thinking. A new way of doing.
Turning Point, an established sector partner, can
guide you through the process.
• Our “needs audit” engages whole
communities including “hard to reach”
audiences with targeted research
• Our recommendations are bespoke to your
community and operational setup
• We can provide change management support
to help you move towards the chosen
improved operation
• We seek optimum efficiency by reducing
duplication, maximising use of resources, and
enabling the community to play a bigger part
in service provision
In the last 12 months Connected Care has
made a difference in communities as diverse as
Gorleston in Norfolk and the London Borough of
Kensington and Chelsea. And in these and many
more examples we’ve helped put the voice of the
community at the centre of decision-making - to
the benefit of communities and commissioners
too. This works. But the model continually evolves
as need changes. Most recently we have adapted
the model to better support CCGs and worked to
develop a payment by results model in Barnsley.
The changing health and social care landscape
means that new bodies such as Clinical
Commissioning Groups and Health and Wellbeing
Boards are coming into being. There are some
central planks of thinking behind the development
of these new bodies, for instance
• community engagement
• placing a priority on understanding local needs
• providing services based on those needs
that build on the views of patients and
communities
The new CCGs are required to demonstrate
that they have a robust engagement process to
underpin decision-making. Engagement is no
longer “nice to have”. It’s essential.
The adaptability of the Connected Care model
means we can focus our efforts to research local
communities, and develop new services, in ways
that suit your situation. Where is your biggest
area of concern? Managing long-term conditions?
Reducing the need for acute services? Integrating
health and social care? Then that’s how we’ll
direct our energy.
Shrinking budgets, increasing
expectations
Connected Care develops bespoke solutions, and
works with you to create a financial model for
your project that works for all sides. We’ve got
confidence in the work that we do. At a time when
the budget reality is as tough as ever, our payment
by results model answers many commissioners’
The ‘Benefits Realisation’ report published by
Turning Point (see p. 11) identified that integration
of health and social care can create efficiency
savings of £2.65 for every £1 spent.
Democratic deficit
Involving communities isn’t easy. Creating
opportunities and shifting expectations away
from local authority delivery and towards a model
where services are co-produced with communities
– again, not easy. But the prize is a big one, and
worth striving towards.
On grounds of cost and service effectiveness,
Connected Care works. The flexibility of the
model allows you to define the goal. Many of
the commissioners we work with talk about
“democratic deficit” – the gap between their
desire to talk to every section of the community,
and the challenges in doing so. Let us bridge that
gap.
For instance, in Kent we conducted research
into the needs of people from Eastern
European communities with drug and alcohol
issues. Interviews were conducted with local
stakeholders and service providers and a set of
recommendations developed for future service
provision. What’s your local issue? How can we
step in to help?
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Community-led Commissioning
A shared vision
Service
review
Strategic planning
Needs
assessment
Priority
setting
Local commissioning partnerships can create a
shared vision of improvement. Connected Care
can assist at any stage of the commissioning cycle.
Are we aligned? If so, let’s talk.
Let’s work together:
• to gain a broad range of patient and
community viewpoints – and then analyse and
act on the insight gained
• to innovate and find bespoke ways to deliver
against tough targets
Evaluation
Performance
management
Review
Monitoring
Community
Engagement
Implementation
Procurement
Service
design
Commissioning
Turning Point provides a valuable external
viewpoint.
• We’ll help you develop better partnerships
with other local organisations
• We’ll help you evaluate what works and what
doesn’t
• We’ll propose joined-up solutions, and help
you develop future opportunities whilst
continuing to meet day-to-day targets
• We take “community engagement” from
theory into practice, enabling you to involve
the community in decisions across the full
gamut of public services
• to challenge preconceptions and address the
root causes of the issues that hamper effective
service delivery
• to build on existing patient and public
involvement mechanisms, and engage with
whole communities including “hard to hear”
groups
• to redesign care pathways for specific patient
groups
• to integrate and streamline service provision
across public, private and voluntary sector
providers
The commissioning cycle should and can involve the community at every stage.
Connected Care provides a method for doing that.
“Working with Turning Point...has reinforced for me the value of starting with the patient’s
lived experience when you are looking to redesign care pathways. As a result of this work
we have come up with some very concrete proposals which will help us deliver tough QIPP
targets. The project is a great piece of evidence for the (CCG) authorisation process but
more importantly the legacy is a fantastic group of community advocates who we can
continue to work with.”
Andy Evans
Chief Executive, HealthEast, Great Yarmouth and Waveney Clinical Commissioning Group
Do you want to move beyond ideas and into
action? Get in touch with Turning Point’s
Connected Care team today:
Gemma Bruce
gemma.bruce@turning-point.co.uk
Do you share our vision? We want to build
community capacity. We want to stimulate
innovative new models of service delivery. We
want to help you redesign care pathways. And we
believe Connected Care provides a starting point
for this kind of development.
Connected Care: doing things
differently
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Experts by experience
In Practice
Local champions
Our community engagement is led by members
of the local community trained by Turning Point.
They have direct experience of using local services
and are committed to making things better for
their local communities.
Simply by participating in Connected Care
research, our Community Researchers come to
understand and appreciate the full variety of
needs that the community has. They bring all
that knowledge to the task of helping shape
future provision. Typically they become staunch
advocates for the services they’ve helped to
develop, and create a long-lasting profile within
their community, helping to signpost services long
after the research role is complete. Often they
become your local champions, helping to create
visibility for the full range of your public services
– including your health and social care agenda
- well into the future. More than half of our
community researchers have gone onto to new
education, training or employment opportunities
as a result of their involvement with Connected
Care projects.
“I was happy to become a community
researcher, as I felt, through my
experiences of life, I could understand
some of the problems people come
across and help resolve them.”
Gill
Community Researcher, Warrington
Connected Care builds more resilient
communities. It creates new social capital, builds
stronger and more supportive neighbourhoods
and develops confidence and networks in the
community. Our work has developed sustained
and lasting mechanisms for collaboration and
engagement between commissioners and local
people, including decisions on commissioning of
services. We have also supported the set up of
community- led social enterprises in local areas.
Most crucially, Connected Care has enhanced
local service provision by improving local services
and awareness of and satisfaction with health and
social care services in the community.
Stimulating new solutions: Connected Care in practice in Norfolk
PROBLEM
Gorleston in Norfolk has an ageing population, a high proportion of people
living with a long term condition, high use of A&E, high levels of unplanned
emergency admissions and low uptake of community based services. The Great
Yarmouth and Waveney CCG, wanted help to reduce ‘heat in the system’.
SOLUTION Step 1
The CCG commissioned the Connected Care team
to engage the local community in the redesign of
care pathways. We recruited a team of community
researchers to undertake research in the local
community. Each researcher brought their own
experience of living with a long-term condition to
the project.
Over a period of 8 months, hundreds of
people from the local community, as well as
commissioners and providers of a range of local
services, engaged with the project.
These local champions:
SOLUTION Step 2
“By talking to people, I have been able
to open their minds to what they could
do by getting involved.”
Les
Community Researcher, Brandon
• Are “experts by experience” - they are
embedded at the heart of their communities,
so they know the issues involved
• Have excellent reach, getting to isolated
sections of the community, and turning the
ideas of the “hard to hear” up to full volume
• Bring credibility to the project through
personal experience of using services
We provide full support and training for our
Community Researchers, and enable them to
share and build knowledge and skills as part of a
national Community Leadership Network.
The research uncovered significant gaps in
perception between professionals and patients
over service issues including treatment delays,
the purpose of A&E services, and the extent to
which patients were managing their conditions
successfully. It became clear that some new but
comparatively simple interventions, such as better
training of care home staff, could significantly
reduce the level of emergency A&E admissions.
A process of service redesign was set in motion,
building on the lessons learnt. Cost-efficiency was
certainly one of the desired outcomes. But at the
heart of the project was the intention to better
support self-management, and to provide better
experiences and outcomes for patients.
TODAY
The project has resulted in the redesign of the care
pathway including the development of team of
lead GPs on long-term conditions, involvement of
community matrons in A&E assessments and the set
up of a user-led ‘navigator’ service based out of GP
surgeries which is a joint initiative between the CCG,
the Borough Council, the County Council, and the
local community voluntary sector. Feedback from
researchers, the CCG, and most importantly patients,
all suggest the project has given a new dynamism
to efforts to improve care services in the Great
Yarmouth area. The redesigned care pathway is being
independently evaluated.
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Turning Point
Resources
Working with Turning Point:
Sustainable, bespoke solutions in
health and social care
The Connected Care model works. Since its
inception in 2004, Turning Point has successfully
delivered projects across the country, engaging
with thousands of people in local communities
and giving them the kind of voice in service
development that has not been seen before.
Our way of working builds on all the knowledge
we have gained over almost fifty years as an
organisation that supports individuals with
complex health and social care needs. Our model
is evidence based and has been independently
evaluated by the University of Durham. It has
championed partnership and collaborative
working across health and social care at a
strategic level, developed more integrated and
joined up working, and involved front line staff
in developing a vision for more integrated service
provision. In addition, Connected Care has
developed sustained and lasting mechanisms
for collaboration and engagement between
commissioners and local people, including
decisions on commissioning of services. We have
also supported the set up of community-led social
enterprises to take on the delivery of local services.
We believe communities are too often
“disconnected” from the services that are
provided for them. Connected Care remedies that
situation. At a time when the health and social
care landscape is changing, community research
of the kind that is central to the Connected Care
method can become one of the new pillars of
service provision.
Connected Care isn’t just about ticking the
box marked “community engagement” when
setting up a new Clinical Commissioning Group –
although it certainly does that. By getting to the
heart of your local community our researchers tap
into hidden ideas, and uncover the roots of some
deep-seated problems. Through Connected Care,
we bridge the divide between commissioners
and communities, developing bespoke health
and social care recommendations that offer real
sustainable support to communities.
The Connected Care methodology has been
rigorously developed to the highest management
standards, and validated against industry
benchmarks.
• High quality quantitative and qualitative
research methods, adapted for each project
• Our training programme is quality assured by
the Social Care Institute for Excellence
• Our researchers ensure the community
engagement programme fits the local context
• We ensure our sample is representative of
local demographics
• Using our knowledge of supporting people
with complex needs to engage “hard to
reach” groups
As a social enterprise, Turning Point has extensive
knowledge of delivering to target within multistakeholder
environments. You benefit from our
• Robust project and risk management systems
• Service design expertise
• Knowledge of the latest innovations in service
delivery models
• Ability to set-up new community-led
enterprises to take on delivery of local
authority functions
How can Turning Point help you?
Let’s talk.
A number of resources are available on our website
www.turning-point.co.uk
Connected Care Impact
Report
Over the past eight years, Turning
Point’s Connected Care model has
supported a wide range of communities
to design and deliver health and
wellbeing services in their areas. This report reviews
the impact of Connected Care’s work to date
and shares our learning on co-production with
leading commissioners, decision makers and the
communities that we have worked with.
The Impact Report is available in “full” and
“summary” versions.
Benefits Realisation
A systematic review of the
economic evaluation evidence for
integrated health and social care
services.
Citizen Advisors: Linking
Services and Empowering
Communities
A survey of different navigator
models across the UK.
For these and additional resources, please contact us or visit our website, and go to:
Community Commissioning > Connected Care > Resources
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Turning Point
We turn lives around every day, by putting the individual at the heart of what we do.
Inspired by those we work with, together we help people build a better life.
Turning Point is a leading UK health and social care organisation. We provide services for people with
complex needs, including those affected by drug and alcohol misuse, mental health problems and
those with a learning disability.
Turning Point
Standon House, 21 Mansell Street, London E1 8AA
Tel: 020 7481 7600
Fax: 020 7702 1456
For more information please visit our website at www.turning-point.co.uk
Turning Point is a registered charity, no. 234887, a registered social landlord and a company limited by guarantee no. 793558
(England & Wales). Registered Office: Standon House, 21 Mansell Street, London E1 8AA.