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An effective workforce for Early Help Delivery

Nuala O’Rourke



The drive to integrationTotal PlaceCommunity budgetsPublic service reformDH drive for Health and Care IntegrationMovement of Public Health into Local AuthoritiesCommissioning of Health Visitors moving to Local AuthoritiesSlide3

The drive to integrationTotal Place lessonsPeople at the heart of service designReducing dependency / enabling self reliancePooling budgetsReducing bureaucracySlide4

The Public Service Reform ChallengeGM Priority: Growth and reformTotal tax intake in GM £17bnTotal public spending in GM £22bn£5bn gapSlide5


Multiple funding and accountability structures make coordinating support for families very difficult

Intensive family intervention worker/ parenting practitioner







Parent support advisers/Schools

Police officer

YOS worker

CAMHS/ Mental Health Worker

Drug and alcohol team



Employment Personal advisers


Young carer

support worker


Family support





Housing link worker



Known Interactions


. 09 to Oct. 10Slide7

What does integration meanMany different modelsCo-locatedAlignedFully integrated under single line managementSlide8

Integration in WiganIntegrated Safeguarding and Public Protection teamIntegrated Health teamLIFE teamSlide9

Integrated Safeguarding and Public Protection teamA partnership response to domestic abuseA coordinated community response modelA co-located team including

Police, Children’s social care, Probation, Housing, Independent Domestic Violence Advocates, Drug and Alcohol outreach, Young person’s violence advocate

With daily input from

Health Economy

Adult Social Care

Process overseen by and approved by CAADASlide10

Delivery ModelDaily meetings which respond to domestic abuse incidentsAll agencies share their knowledge of the whole familyA joint action plan is jointly agreed and implemented immediatelyIndividual agencies take ownership of on going activity with the family

Taking MARAC principles to a daily meeting

Launched in March 2013Slide11

Integrated Health Support TeamAn integrated targeted intervention and support service to vulnerable pregnant women and their families. Works with top 2% most vulnerable pregnant women in the Borough (circa 75) and their families to reduce the risk of children becoming looked after and / or suffering significant harm.Team consists of Public Health midwives, Midwifery Support, specialist Speech and Language therapist and a targeted Speech and Language therapist, Family Support Worker

Won 2 national awards from RCM & BJM.Slide12

Delivery ModelJoint assessmentsJoint team meetingsShared case notesJoint visitsShared family planSlide13

The Life ProgrammeA long term attachment rooted service where families are invited to take part and work intensively with a range of workersA team of workers with a range of skills including police, social care, early intervention, health and housing.Located in a local building which operates as a drop in centre for family membersSlide14

Delivery ModelAll workers support families and share their expertise with the teamStaff have specialist areas – but all members of the team carry a case load and act as a keyworker for the family – or members of the familySmall case load – 12 families on each site – but as this includes the extended family it adds up to nearly 100 individuals.Staff work with families for a period of up to two years with a defined exit plan seeing a step down in the level of support over an extended period of timeSlide15

Learning – Aligned IntegrationWorking in a co-located team can blur the lines between professions and need all involved to have a flexible approachThe benefits are not shared equally across all agencies and without shared budgets the cost can outweigh the benefit to some partnersRelationships and engagement are critical to success and the timeliness of appropriate interventions is key to delivering and sustaining change.Slide16

Learning – Single teamAll staff need adopt a person centred approach to family work with a single family assessment built into the centre of the approach so that we ensure that the child’s needs are paramount and services wrapped around the family

Having all professionals managed within one team enables the change process to be managed, removes competing agendas and prevents the family from playing off professionals


means that team members are team members first and carry their professional skills on their shoulder to be used as and when needed by family members or other team members.Slide17

What helps develop the single teamHaving a job role outline that defined the role of the team member.Some common competencies that tied the team together,Common statements that outlined the primary task that we were all working together to achieve


set of

fundamental principles

that set out the way that we worked with



acknowledgement that as a team we had different sets of value bases and motivation for the work that we do. 


the fundamentals within the IPA process so that we could measure our journey.

Providing daily debriefing sessions in the early days of integration supported by a manager.  Understanding that t he team moved from roles where they had been seen as the expert in their specialism working with a particular cohort to working outside their comfort zone. 

Staff need support to understand that they don’t need to know all the answers, its ok to say I'm not sure but we can find out.

Recognising each individual team member as a consultant from their specialist area.  Being open to share working practices.  Involving the team in the development of the service.Providing high quality supervision and support to enable team members to manage the change in the way of working.Slide18

LearningWe are asking our new integrated teams to support families into behaviour change which the public sector has been struggling to achieve for many yearsNeed a workforce than understandsWe need to take an asset based approach with familiesFamilies and individuals need to be encouraged to take responsibility for their behaviour and understand the impact in order to be willing to change.Behaviour

change takes time and families often relapse and need further motivation and supportSlide19

Aim in WiganTo develop and begin to implement by 2015/2016 an approach to full integration of early help including Health Visitors and our Early Help team.Locality based modelSingle line management of staff Slide21

What are the challenges we have identifiedCommunication:Need for an agreed shared vision and understanding with clear communications strategy:Strategic partners / managementWorkforcePublicAccountability / governance / clear leadership.Slide22

What are the challenges we have identifiedAccountability Governance Need for clear leadershipAbility of organisations to let goSlide23

What are the practical challenges we have identifiedSystems:Fragmented commissioningRange of assessment processes and paperwork to be agreedData: systems / sets / sharing

Working models e.g. key


/ corporate caseload


What are the challenges we have identifiedWorkforce:Workforce sign-up.Workforce competencyWorkforce cultureChange managementHR / Pensions /


Discussion topicsWhat type of integration are delegates developing in their locality?Do we all share the same challenges?What do we see as the benefits of integration?How will we measure our success?Slide26

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An effective workforce for Early Help Delivery - Description

Nuala ORourke Wigan Council The drive to integration Total Place Community budgets Public service reform DH drive for Health and Care Integration Movement of Public Health into Local Authorities ID: 245606 Download Presentation

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