In 2013 the Wakefield district had a number of challenges facing adults’ services – we had an ageing population, austerity, increased pressure on acute services, and an overstretched workforce. We knew we had to try a new approach and we responded by creating Connecting Care – a programme creating integrated teams made up of NHS staff, social workers and the voluntary sector in order to deliver better care for older people. It was a large, resource-intensive programme.
From the start, we agreed to invest in quality evaluation so every six months we undertook interviews with 40 members of staff. Each tranche of interviews resulted in findings which supported action learning and fed into subsequent developments. We continued with this approach for three and a half years.
We are now embarking on the next chapter of our integration journey and as the Director of Public Health I have been reflecting on the process of the evaluation of Connecting Care and how this added value to the programme. I remember being at the final evaluation event and looking round the room of over 100 staff all talking animatedly. I was struck by how much things had changed over the last three years.
Then there had been less than twenty staff who had been bribed with chocolate biscuits and cups of tea to attend the first briefing from the staff evaluation. The staff at this first event didn’t want to be there, all sat with people from their own agency and were unconvinced of the benefits of integration. Fairly quickly the briefing disintegrated into debate between the various organisations about whether we should use the term ‘service user’ or ‘patient’.
However, three years later things really were different. Staff from different agencies were all sitting together, chatting and clearly valuing each other’s company. There was a real energy in the room and the attendance had more than quadrupled. During the meeting we heard from all of the multi-agency teams about how they were working together and more importantly delivering better outcomes for the local population, evidenced by parallel service user research commissioned through our local Healthwatch.
Now in 2021 and as Corporate Director for Children’s Service I am leading the next stage of our integration journey, bringing children and young people’s services from across the district together under one newly created joint Service Director Post for Children’s Health and Wellbeing. Wakefield district’s children’s services have been on an improvement journey since an inadequate Ofsted judgement in 2018, but we have always known that improvement would only be sustainable if underpinned by transformation and strong partnerships.
Over the last 18 months, we have therefore embarked, as a partnership, on an integration programme of children’s services which we have all signed up to under the banner of ‘Wakefield Families Together’. Our early focus has been on the operational arrangements and the foundations are now laid for integrated teams working together – albeit still virtually – in six cluster arrangements. Based on initial work we undertook with Stockport and shaping ‘local conversations‘ and support around schools, early years’ providers and neighbourhood community safety partners, our Wakefield Families Together model focusses on joint problem solving before issues escalate.
Where services are required, local discussions including children, families and young people are aiming to identify who is best placed to provide the right support at the right time. Teams as diverse as our police, social workers, family support staff, emotional wellbeing, CAMHS and health visitor services have all started to adjust their structures and ways of service delivery to ensure we are increasingly more than the sum of our parts, but more importantly to enable families to access the support they need at the earliest opportunity and at the lowest level of intervention.
Our Service Director appointment is the final piece in this jigsaw. This post is funded by Children’s Services, the Clinical Commissioning Group, our Mental Health Alliance and Public Health and will lead a team of senior staff from a range of early help, health and emotional wellbeing commissioners and providers. The post will be leading this team ‘by consent’ from their originating agencies, who will retain their employment arrangements, thus pooling talent, ideas, skills and budgets and delivering our joint objectives without the need for major changes of terms and conditions. We believe that this is a really exciting opportunity with the potential to transform the way we do things to really improve outcomes for our children and families and increase staff satisfaction.
Evaluating the impact of change and contributing to the development of evidenced based approaches is a key part of the model and the way we want to work. It is for this reason that we will use a similar approach to our evaluation of the integration in Adult Services, fully engaging staff in the evaluation. We want to do this in a co-productive way with staff and families themselves creating the research questions about things that matter to them.
We are really excited to be working with Research in Practice as one of their member organisations to develop this work.