Memorandum submitted by Turning Point,
Centre of Excellence in Connected Care
1. INTRODUCTION
The Centre of Excellence has been established
by Turning Point to champion Connected Care, a new model for service
delivery that integrates health and social care services in the
most deprived areas in England and Wales. Communities are central
to the design and delivery of those services. The Centre of Excellence
was established in November 2007.
People living in the poorest neighbourhoods are likely
to experience significant gaps in health and social care services.
Research carried out by Turning Point, in conjunction with ippr
(Meeting Complex Needs, 2004) shows that those people living in
areas of highest deprivation are likely to have a broad range
of interconnected needs.
There is a clear congruence between the priorities
of commissioners to deliver services differently in the most deprived
communities, and the delivery of concentrated interventions that
take account of the health and social care outcomes of each population
as part of Turning Point's concept of Connected Care.
The Centre of Excellence's work is overseen
by an external Steering Group, chaired by Gerald Wistow, with
membership that includes Mike Farrar, Chief Executive, SHA, North
West. The Centre of Excellence is carrying out Connected Care
in Hartlepool, Bolton, Suffolk and Warrington.
2. CONNECTED
CARE
The Centre of Excellence has developed a unique
model of community engagement and service integration, "the
Connected Care audit", to support commissioners to better
understand the needs of communities, and inform their future commissioning
decisions.
The Centre of Excellence has strategic oversight
and provides expertise at all stages of the Connected Care process—from
initial interest, through audit and evaluation to the development
of a service specification and service delivery as set out below:
3. THE CONNECTED
CARE AUDITS
The diagram below illustrates the proposed key
stages of the Connected Care process once the geographical areas
for Connected Care have been identified locally. Each is then
described in more detail.
(a) Establishment of the governance and accountability
structures
The Centre of Excellence will provide advice
in establishing the appropriate governance and accountability
structures taking into consideration the values and principles
that underpin Connected Care. Connected Care needs to be overseen
by a local steering group comprised of local agencies and community
representatives and others from the identified geographical areas
who have a stake in how health and social care services are delivered.
(b) Desk research and resource audit
Our desk research gathers information previous
research and consultations that have already taken place in the
community or in the wider locality, as well as regional and national,
current and future developments. This exercise helps to identify
the themes and priorities locally and to inform the Connected
Care audit, cost benefit analysis and approach to evaluation.
(c) Recruitment and training of community
members
An important element of Connected Care is the
recruitment of community members and involving them in the design
and delivery of local services. A programme of training is embedded
at the start of the process to develop research skills and confidence
within the community, and to raise awareness of the principles
behind Connected Care before carrying out the audit. The training
programme provided by the Centre of Excellence has been supported
by Social Care Institute for Excellence (SCIE).
(d) Connected Care framework
The audit is based on the Connected Care framework.
It is used as an established tool to gain a range of views about
the health and social care needs of the community, identifying
what works well and what needs to be improved upon in terms of
accessing services. This qualitative research tool provides a
means of "getting beneath the surface" of attitudes
and opinions and of exploring complex or sensitive areas.
(e) Using the Connected Care framework
The Centre of Excellence uses a variety of participative
methods to engage with the community. These would include door-to-door
surveys, on-line surveys, face-to-face semi-structured interviews,
stakeholder workshops and events, focus groups with community
members and community "Come and have your say events".
We also ensure that we report back to the community in an accessible
and inclusive way.
(f) Production of audit report
The emerging data from the audits is analysed
and presented thematically in a final report. The combination
of qualitative and quantitative methodologies in the audit process
provides the evidence to inform a service specification for the
design of Connected Care services (see below).
(g) Cost benefit analysis
The cost-benefit model is a bespoke tool designed
for commissioners to help test out with them at an early stage
the cost-benefit implications of Connected Care on the provision
of health, housing and social care services. It will map, from
the commissioners' perspective, the current flow of resources
across health, housing and social care and then model the consequences
of new decisions made by commissioners within a Connected Care
environment.
(h) Drawing up the service specification
The purpose of the Connected Care audit process
is its translation into a service specification for an integrated
service locally. In order to write the service specification,
it is essential that a common understanding is reached regarding
the format and content of the future Connected Care service based
on an options appraisal. To achieve this, the Centre of Excellence
would hold awareness raising workshops involving commissioners,
agencies and local communities. Importantly we will aim to bring
together in-group sessions with agencies and providers of different
types of services (health, housing, social care).
(i) Evaluation
We build in evaluation of the project in order
to give communities and commissioners the information they need
about outcomes of the Connected Care audit and service and to
demonstrate the effectiveness of our work. A Connected Care outcome
framework is adapted to reflect the different priorities in local
areas.
4. COMMUNICATIONS
STRATEGY
The Centre of Excellence would provide overall
guidance and support in developing and implementing a communications
strategy locally. Shared, accessible information and consistent
communication channels will help both the communities and agencies
understand the priorities of Connected Care and manage expectations.
5. SUMMARY OF
OUTCOMES
The main outcomes are:
— Regular progress reports to the Steering
Group overseeing the Connected Care process;
— Connected Care audit reports profiling
the breadth and level of needs within the community and a series
of recommendations of what the communities considers essential
in redesigning services;
— Based on the audit report—work
with other agencies to identify common themes and make recommendations
for a service specification for integrated Connected Care services;
— Communities of locally trained and
grown researchers in community research, audit, information gathering
and consultation techniques;
— A report with findings from the cost
benefit analysis using local data with clear and realistic recommendations
for future allocation of Connected Care services;
— Service specification for new Connected
Care services in the proposed areas for Connected Care and support
leading to the establishment of integrated services; and
— A bespoke outcomes framework with
evaluation looking at outcomes for the individual, community and
commissioners and the cost effectiveness of those interventions
Richard Kramer
Director
October 2008
| 
