Saving the human race – delivering health and care beyond the walls

1. Saving the human race – delivering health and care beyond the walls

2. Introductions and aims of the session – Chair, Elaine Meade • Understand key success factors from early years improvement work • Understand how Asset Based Community Development can help focus improvement work • Explore techniques for engaging communities and families in the improvement work

3. Judith Ainsley

4. Ambition To make Scotland the best place in the world to grow up in by improving outcomes, and reducing inequalities, for all babies, children, mothers, fathers and families across Scotland to ensure that all children have the best start in life and are ready to succeed

7. Our context Community Planning Partnerships - Partners work together to achieve positive outcomes for citizens (5m) Multi agency approach Children from 0-8 Health inequalities Social inequality 170,000 children live in poverty Early Years experience has a substantial impact on outcomes

8. The Early Years Collaborative been building will& generating ideasfor a while! Knowing is not enough; we must apply Goethe

9. Early Years Collaborative

10. Stretch Aims • Positive pregnancies which result in the birth of more healthy babies by end 2015, through a reduction of 15% in the rates of stillbirths and infant mortality. • 85% of all children reached all of the expected developmental milestones at the time of the child’s 27‐30 month child health review, by end‐2016 • 90% of all children reached all of the expected developmental milestones at the time the child starts primary school, by end‐2017 • 90% of all children in each Community Planning Partnership area will have reached all of the expected developmental milestones and learning outcomes by the end of Primary 4, by end-2021

11. The story so far • Year 1 practitioners chose tests of change and became familiar with the method • Year 2 we identified key changes • Now have 40 Pioneer Sites • Faster learning for scale and spread • 4 Learning Sessions • Learning Session 5 on 9 and 10 June

12. Importance of using our Assets • Massive change across the public sector • Scarcity of economic resources • Health and Social Care Integration • Children and Young People’s Act • Lots of improvement activity • All working to improve things for the same children and families

13. grow diminish • Natural resources • grow with use • relationships • commitment • community • Economic resources • diminish with use • money • materials • technology • Adapted from Albert Hirschman, Against Parsimony • & @helenbevan

14. 1140 -1145 • 1410 -1415 Video • ABCD in the Early Years Collaborative

15. 1145-1200 • 1415-1430 Angela Glassford – Head Teacher • ABCD – Assets Based Community development • Shared understanding of asset based work - what this looks like in your context (values and approach) • What did we set out to achieve and why? What was the plan and how things happened? • Sharing some of the specific ways in which we engaged with children and their families to develop both individual and community assets (our change ideas) • How this enabled us to deliver better health and wellbeing outcomes and experiences for the children in our locality • How this fitted with our local priorities? The infrastructure to support it. • How we plan to spread and sustain this approach as we move forward

16. Early Years Strategy • Recognised need to focus on early years • Multiagency responses • Workshops to develop model • Culture Change • Family Focussed Approach • £6.8 Million investment

17. Delivering! Salutogenesis Growing health and wellbeing

18. Locality Model Ferguslie and Linwood (Pathfinder Areas) Core Teams in each locality Mapping of existing community assets Strengthening of links between existing services, including third sector Integrated practice across the disciplines Building universal services and increasing community capacity Targeting support in partnership with families

19. What do families tell us? Someone to listen to me…not numerous people I have to tell the same thing to again and again More support with mental health Someone to help me see what my problems are and with support, how I can solve them Someone to look at my whole family and not just judge me More time with someone helping me Contact with others so I don’t feel alone Someone to tell me when I’m doing well…this really worked!

20. Core Team Structure Locality Manager

21. Evaluation criteria Family centred Responsive early intervention Integrated working Flexible delivery of services Adding value Minimising barriers Scalable Measured against shared goal setting

22. Giving Our Children the Best Start in Life – A Strategy for the Early Years in Renfrewshire John Trainer Angela Glassford

23. Sustain and Spread • “It’s not what you do it’s the way that you do it.....” • Link back to families as the driver of change and development • Outreach • Organisational change • Convert and enable • Security of funding commitment • Political will

24. Driver Diagrams • 1200-1215 • 1430-1445

25. Knowledge for Improvement Subject matter Knowledge Appreciation of a system Theory of Knowledge Psychology Knowledge for Improvement Understanding Variation Values

26. Appreciation of a System Where in the System of Profound Knowledge are we learning? Theory of Knowledge Psychology Understanding Variation Values

27. What is a theory? • A description of our best understanding about why things are the way they are • Theories/beliefs in other contexts? • Economics – game theory • Biology - theory of evolution • Physics – string theory • Metereology – chaos theory • Assets Based Community Development…?

28. How is a theory different from a belief? • A theory can be tested scientifically • Theories are predictions of the outcome of future events • Theory is the starting place for generating new knowledge

30. Project Driver Diagram

31. What do we believe about why things are the way they are? • Evidence – what objective evidence have we collected locally or is available to us through the relevant literature? • Local subject matter experts – people who work at the frontline who experience the system day to day and have strong experiential beliefs about where change is needed

32. Some guidance on creating a driver diagram • Start with the outcome in mind – develop an aim statement that reflects the desired future state • Primary drivers should be nouns that reflect the key leverage points in the system of interest from three areas: • Structures – physical, financial, administrative, management and improvement, delegation and accountability • Processes – workflow of the system, how things are accomplished • Operating norms – written and unwritten rules that govern behaviour

33. Some guidance on creating a driver diagram • Secondary drivers must be tangible things where action can be taken on the system • Change ideas should link directly to secondary drivers and should exhibit these characteristics: • Specific - each change idea needs to be clear and concise and it must be obvious how its introduction is different from the status quo • How to - each change idea must include a statement about how and where it will be put into practice within the system

34. So can we use this approach today? • 1215-1220 • 1445-1450 Table time to develop your own aim – 5 minutes

35. 1225-1240 • 1455-1510 TRIZ Change ideas - using Triz as a mechanism to get the elephant in the room and the change ideas on the table!

36. How could we STOP Assets Based Community Development? 5 minutes table work to get ideas – be as radical as you can be! Make a list of all you can do to make sure that you achieve the worst result imaginable with respect to ABCD

37. From your list – cross out everything ABSOLUTELY not possible 5 minutes Go down this list item by item and ask yourselves,: • Is there anything that we are currently doing that in any way, shape, or form resembles this item? • Be brutally honest to make a second list of all your counterproductive activities/programmes/procedures

38. So what are you left with? 5 minutes – feedback Go through the items on your second list and decide what first steps will help you stop what you know creates undesirable results • Are these your secondary drivers or change theories to work on?

39. Group your change ideas at your table feedback

40. Now populate the Driver Diagram What will be different at the level of: 1 5 25 125 625 ????

41. 1240-1245 • 1510-1515 SUMMARY • Next steps • What are you going to do by next Tuesday?