co-production and commissioning workshop report

Co-Production and Commissioning Workshop Report

w www.WorkingWithNotTo.com e [email protected]

@WorkingWithNot2 Event Location Flintshire

Date 02.04.2014

Session presentation by Craig McCleod, Senior Commissioning Officer, Flintshire County CouncilReport produced by Pam Luckock & Fran O’Hara. Directors ‘Working WIth Not To’ Co-Production

Project, working with people at Meetup 5 and our community

Visual Minutes: Scarlet Design Team

3CO-PRODUCTION AND COMMISSIONING WORKSHOP REPORT 02.04.2014

The many and varied challenges of co-production commissioning had emerged as a theme during our conversations with our community in North Wales over the last few months. Craig McCleod and Mark Cooper from Flintshire County Council agreed to sponsor Meetup 5 and to speak on the topic. They also encourage people to come, so the conversations we had were as rich and valuable as possible.

Good commissioning is critical to delivering high quality outcomes for people, whatever the service they require. Looked at through an equality and human rights lens, the person in receipt of the service must be placed at the centre of the process, from commissioning to delivery.

This sharing of power and budget transforms the process, and requires new conversations and learning on both sides. Having worked with two county councils in North Wales we could see that the importance of people working together to create their own personalized model that worked for their service. This requires people to move out of their comfort zone, and really listen each other, and use the learning’s to inform their approach.

At the meet-up our first aim was to create a warm hospitable space where we could contribute in the way they wished. We learnt a lot from the workshop, both in the outcomes and how to facilitate better conversations. The outcomes from the day speak for themselves, we hope you find this report valuable and do please share your insights with us. Also your suggestions for workshops at future meet-ups.

We also want to take this opportunity to thank Craig and Mark for their unwavering support and enthusiasm for encouraging us to start WWNT and throughout our first 12 months. Without these two key ‘gate-openers’, and many, many others, we would not have had courage to grow the project.

Pam Luckock & Fran O’HaraDirectors, ‘Working With Not To’ Co-Production Project

CO-PRODUCTION AND COMMISSIONING

© S

CARL

ET D

ESIG

N IN

T. LT

D 20

14 M

APS:

WW

W.F

RANO

HARA

.COM

4 CO-PRODUCTION AND COMMISSIONING WORKSHOP REPORT 02.04.2014

Craig Macleod - Flintshire County Council. Co-Production & Commissioning

6

© S

CARL

ET D

ESIG

N IN

T. LT

D 20

14 M

APS:

WW

W.F

RANO

HARA

.COM

CO-PRODUCTION AND COMMISSIONING WORKSHOP REPORT 02.04.2014

PHOTOSTORY


© S

CARL

ET D

ESIG

N IN

T. LT

D 20

14 M

APS:

WW

W.F

RANO

HARA

.COM

PHOTOSTORY


© S

CARL

ET D

ESIG

N IN

T. LT

D 20

14 M

APS:

WW

W.F

RANO

HARA

.COM


Integrate Social Services with Health: • No power struggle • No arguing over cost • Put the person first • Not so much red tape • Makes sure staff (workforce) know how to co-design,

embrace ‘Freda’ • Skills: active support; inclusive communication • Person centred approval • Like, admire, important to • Unified assessment • Needs deficits, risks • Lessons to learn from learning disability approach > but

how upscale to volume within other populations?

TRUST • DECISIONS • RISK • “Good commissioning” • Clarity of roles and responsibilities: • Local authority | • Provider | > Relationships • Citizen |

Local authority: • Broadest – not just about social services • Broader – preventative and wellbeing role • Statutory agencies: managing fear of risk and not over-

egging duty of care

• Flexible • Innovation • Person centred

– what can you do • Shaping communities • Local community grants rather than commission • Using person centred approaches • Encouraging peer support • Outcomes focused • Look at assets – the individual and the local community • Listening to what people want and how to help/support/

enable them to achieve that • Positive risk taking – as a shared experience • Balancing what is important to someone with what is

important for someone • Encouraging autonomy – greater control • Helping to shape services in the way that people want

– working with individuals, families and providers – a shared approach

Who has a say: • People receiving the service • Getting their views, thoughts and experiences • People delivering the services • Good insight • Working together effectively – partnership working • Which?: Partner? Competitor? Enemy?

GROUP DISCUSSION TABLESHEETS



• Good • Promotes innovation • Takes balanced approach to risk • Not unduly restrictive / prescriptive • Address prevention – low-level interventions • Lighter touch to reporting • Let’s go – loosening its grip • Co-designs service models

Start with the person • What do they want? • Listen and act • Ideal – individual budget – design my service (but with

support) • And/or – are people wanting things that aren’t available • Co-design and produce • Look at ‘resources’ in the community • Access to good practice from other places

Keep it simple • Use personal networks • Stop creating competitiveness (prevents co-production) • Local area coordination • Work together in communities and across services

Know what’s available, legal and possible • Commission someone/organisations/groups asking what

people want for their life, and asset mapping • Then only commission services that are needed so

people achieve what they want. i.e. commission more community strengthening things. Expect to commission fewer “core services”

• Its not just about commissioning, its about de-commissioning

• Stop trying to protect company interest’s and put peoples interests first

• Direct payments are a great way to commission exactly what you want

• First barrier is needing a service but only ‘moderate’ so get nothing, so nothing commissioned

Models: • Dutch social brokers • Bob Broad L.A.C. • Asset maps • Local services – local knowledge • One stop shop • Outcome focus


Local assets: • What is there? • What do we need? • What to stop? • Specific outcomes: • Continuity of support • Staffing/skills/knowledge • Find small, local before commissioning • Don’t formal commission first • There’s a gap between ‘what I need’ and ‘what I can

have’ • DPs – DIY commissioning and support • People don’t fit in boxes • Battling all the time as a service user • Want to be free from the tick box • Stereotypes

Creative solutions > outcomes • Turn negative assessments into positive • Needs to be outcome based i.e. outcome of individuals • Commissioning should be done together start with a

‘blank sheet of paper’

Positives: • Has improved life slowly • Improved wellbeing, socialise

• Social life outside the world of disabilities • Feel inclusive • Built confidence • Better mental health, fight! • Change attitudes

Negatives: • Wasting money – could be spent better • Always after tick boxes • People don’t listen to what we want • No prevention work currently – fighting with demand • Broken communities • Listening in other ways • Positive thinking • Control – money • Give people more responsibility they know what they

want • Communication • Communities in control • LA monitoring/standards

Consult on: • What services exist? • What would you like to have? • Number of people benefitting from service. Who are

they? • Think ahead about the issues • Understand what everyone is doing



• Review/check • Listen people • Make things better • Take action! • Self help! • Myself and everyone else • Buying the right services for the right areas • Reviews/checks/listen to what they need • Action plans

Keep on at them: • Go above them • Keep phoning • Email • Meetings • Send letters

How do you know/find out about the assets in your community? • Space and time for statutory services (social workers) to

have conversations? • Better links/knowledge exchange between third sector

and public sector • Secondaments? • Back to floor for service managers • Service providers that include/employ service users?

(Barod example) • Turn around the question… not what do you need? More

What can you give, assets focus?

• Making the time to do things properly – not ticking boxes or filling in bits of paper

Lived experience: • How do you find out this? • Mystery shopper • “Trip advisor” for respite care • Buddy system • Loneliness and isolation – a big factor in shaping services

correctly

Important: • Person centred planning – should be at the heart of all

the commissioning • Use volunteers – make sure people can be heard in

places such as care/residential homes

Better ways and new ways to find out if commissioned services are actually meeting need: • ‘Moles’ • ‘Spies’ • Buddies • Secret shoppers • Reviews on the net • Technology • Volunteers • Ways to find out what assets are out there • Making time for ‘proper’, meaningful co-production • “Care” is only provided by unpaid ‘carers’ paid support



workers are not ‘carers’ • Everything to do with disabled

people must be based on a social model paradigm

• Outcomes – not outposts

• We can afford high quality social support neither Wales or the UK are poor

• Value not cost • Focus on what matters – not paperwork filling

Co-production: • Get out to see pressures – what is out there and

understand • Secondments 3rd public services need to understand • See services first hand quality of services • Need to ensure robust processes to check quality – vital

that people are asked • Care/respite providers need to be monitored from the

inside out, not outside in! (Care checker?)
