Resolving Chaos: Looking forward to challenging times ahead

1. Resolving Chaos: Looking forward to challenging times ahead

2. Resolving Chaos was created in 2012 to improve commissioning and transform services for vulnerable people with complex needs We aim to prove that user choice is cheaper and achieves better outcomes through: • Promoting individual choice and personal responsibility • Business cases for changing public investment • Creating communities of collective interest

3. What we deliver • Innovative Service Delivery (Big Lottery Fund South London and Hertfordshire) • Personalisation (E-Choice Channel) & User Involvement (ESURG) • Economic Business Cases (Feasibility study South London, Hertfordshire and Islington) • Connecting Communities - Supporting the VCS to become more enterprise focused (Hertfordshire) • Commissioning support and evaluation (NHS London JIP Pilots)

4. We collaborate with a wide range of organisations

5. “If agencies in localities pool resources and work more closely together to identify and deliver services to adults with complex needs and chaotic lifestyles, they will be able to achieve a more cost effective service, and deliver interventions, solutions or improvements which are more customer focussed and effective.” Hypothesis

6. Overview of our work Feasibility studies – scoping local services and systems Multiagency practitioner workshops • What works? • What doesn’t? • What can we change? What practitioners want: • More multi-agency case conferences • Better sharing of information between partners • A focus on high cost people with long standing problems • To share what has been tried before and formulate new approaches

7. Scoping a Local Client Cohort • Identifying clients – e.g. ‘Super Wednesday’ • Transactional analysis and Tariff of costs • Overall system cost

8. 2 year costs, Lisa = £136,574

9. Interviews with individuals with lived experience Interviews Small group of individuals whose historic service use was audited interviewed by Resolving Chaos about their experiences. What they want: • Consistent Trusted Adult • Choice – when, where and how they receive support • To create their own package of care • Support at points of transition – e.g. moving from Hospital or Prison back in to the community or leaving care

10. What have been the findings of our feasibility studies? • There is a high cost/low outcome local cohort • Significant sums of money are being spent but not resulting in sustainable improvements to their lives • A wide range of services are used – These are disconnected in 3 ways • Information sharing between agencies • Capturing cost and outcomes data on people of shared interest • Providing consistent, long-term support

11. Hertfordshire : Actual example of Pooled Funding Project Nominated for an LGC award 2017 Investment was pooled from all key partners in Hertfordshire: • Police and Crime Commissioner • Hertsmere Borough • Three Rivers District • HCC • Herts Valley CCG • Affinity Sutton Housing • Watford Community Housing Trust • Thrive Homes • Aldwyck Housing

12. Our service model in Hertfordshire • Partnership of RC and SLaM – bringing learning from the LSL fulfilling Lives service model, which is successfully supporting people with long histories of non-engagement and lack of successful outcomes • SLaM bringing clinical expertise and operational management to team • Will work with partner agencies to agree nominations, agree service data and plan individual client engagement strategies • Will employ multi-skilled team, reflecting client needs

13. BLF Fulfilling Lives in Lambeth, Southwark and Lewisham • An eight year programme – ‘You First’ - delivery team to work through a local partnership to improve lives for high cost/ low outcome cohort • Peer Development integral to the service model - peer advisors working with key workers • Partnership of local commissioners, providers and NHS agencies • ‘Test and Learn’ approach • Economics evaluation working with Kings College London’s Health Economics team (KHE) to evidence where service models do, or do not, help achieve positive change for individuals with a range of complex and multiple problems. • Personalisation Initiative with 7 other national Fulfilling Lives projects - leading on development of a community of practice focusing on using or developing personal budgets and a personalisation approach.

14. What we aim to achieve • People with multiple and complex needs can manage their lives better through access to more person centred and coordinated services • Services are more tailored and better connected with the community and will empower users to take part fully in service design and delivery • Shared learning and improved measurement of outcomes for users to demonstrate the impact of service models to commissioners • Making a difference - demonstrating impact (quantitive and qualitative evidencing) • In short : system transformation through reinvestment in prevention

15. 3 years on – What we have learnt • Necessary to speak the commissioners language – an economic business case as an evidence base • Local priority setting - Integration into local commissioning plans eg: Health and Wellbeing Boards • Individual choice – challenges vested interests and disrupts the existing market • Sustainability with less funding – develop new multi-agency partnerships and integrate funding locally • New mechanisms of funding eg: crowd funding initiatives, social investment • Co -design with people with lived experience and local communities

16. Looking forward to 2017 • Fantastic opportunities in place to build on our work this year eg: Big Potential /social investment • Demonstrate user led choice is cheaper and improves lives – with KHE partners produce a winning business case for sustainability • Personalisation : lead the national agenda for this client group

17. Thanks for your time – any questions or comments? Ann.skinner@resolving-chaos.org - CEO Resolving Chaos