Wigan Council

Place Based Public Services Integration

Briefly describe the initiative/ project/service; please include your aims and objectives

Securing improved outcomes for residents of the borough, at a time when the budgets for public services are under intense pressure requires public service partners to work together in a radically different way. In Wigan Borough we already have evidence that supporting residents to be independent and in control of their lives and connected to their communities can substantially improve their outcomes and reduce demand for public services.

A key element of this work is to recognise that residents live in communities and expect public services to work together in those places to support them to achieve their ambition. All public services increasingly recognise that the ability to improve outcomes and reduce demand for their own service often lies with other public service partners. It follows that public services in the borough need to have a common “currency” by which we can create opportunities for public service staff, from whatever organisation or sector, to work together, and in the context of a shared approach.

What are the key achievements?

Our Place based approach started on 01/04/17 with the appointment of 7 Service delivery Footprint Managers.

Aims were to;

  • integrate services based around the person and the place
  • focus on prevention and early intervention
  • reduce demand on statutory and crisis interventions

The following has since been achieved:

  • Principles of Place based integration a greed across the public service partnership
  • Seven Service Delivery Footprints (SDF) established and agreed with partners
  • Joint operational oversight and management across partnership
  • 7 SDF managers appointed in April 2017 to coordinate the public service offer across the place
  • 7 MDT case management Huddles established focusing on 715 families and 989 individuals
  • SDF Locality Hubs identified for multi-agency staff to work from
  • 7 Multi Agency front line workforce meet and greets delivered in June – July 2017 and 7 Middle manager training sessions
    delivered in May 18
  • Staff equipped with technology and tools to enable them to work flexibly in the place
  • SDF profiles developed
  •  Other public sector services aligning staff to the SDF model
  • Costed case studies developed

The feedback from staff evidence improved outcomes for residents

What are the key learning points?

Whole system strategic leadership across all partners is key to delivering the changes required . Enablers are key in
supporting staff to work differently:

  • Workforce development and training
  • Enabling front line staff to have agile kit and ensuring wifi connectivity so decision making can take place in real time
  • Having a convenor of place – for us the SDF Manager to coordinate and build team environment across differing services and
    cultural ways of working
  • IG support
  • Working with our voluntary sector as partners in our delivery of services challenges
  • IG – differing levels of understanding around consent and sharing of information
  • Services and organisations reluctant to change they way they work
  • Staff unsure about the complex matrix management in the Place
  • Systems and referral processes that stop services from offering much needed support – referral systems and thresholds
  • Financial pressures meaning front line staff don’t get the agile kit required to work differently
  • Meeting needs of services and not prioritising needs of people
  • Changing the way staff work to move beyond their silo or service and offer a key worker approach

Additional Comments

As our work continues we will develop further evidence of the intervention but we will also routinely review a number of key metrics of public service demand reduction/improved outcomes, both at a borough level and at a SDF level. These metrics will include the following indicators of reactive public service cost and resident experience:

  • A&E attendances
  • Unplanned hospital admissions
  • Number of Looked After children
  • School readiness
  • GMP activity
  • Adult Social Care Cost
  • Healthy Life Expectancy
  • Loneliness and community connectedness

It is recognised that progress against these and other indicators does not in and of itself constitute an assessment of the effectiveness of place based working. It does however constitute a high level assessment of the final outcomes of a number of interventions across the borough, of which one is the alignment of public service into 7 SDFs. We contend it is hugely methodologically challenging to conduct an evaluation of this scale however, it is plausible from staff and resident testimony to date that place based working is making a contribution to improved outcomes and financial stability.