Public services co-production in Scotland: Challenges, policies and good practice cases All in this together: co-production, co-creation & public service delivery Cardiff, 23

Report
Public services co-production in Scotland:
Challenges, policies and good practice cases
All in this together: co-production, co-creation & public service delivery
Cardiff, 23 February 2012
Governance International
www.govint.org
How to move from top-down service delivery?
Cartoon Ruderer
... to co-produced personal and social
outcomes?
3
What will be the most
important challenge for
your organisation in
2012...?
A question for you …
A. Improve the quality of public services for
citizens?
or
B. Help citizens to improve their quality of life?
Let’s be more specific:
What do older people with visual
impairments need most?
Study on the needs of elderly people
with visual impairments
What public managers and staff think elderly people need:
 More information about public services (64%)
 More information about specific support (54%)
 Get to know people and make friends (36%)
 To talk with someone about personal issues (18%)
What elderly people really want:
 Get to know people and make friends (91%)
 To talk with someone about personal issues (62%)
 More information about public services (53%)
 More information about specific support (47%)
Source: Martin Willis and Eileen Dunstan, University of Birmingham, 2009
6
Scottish Context
• Demographics – population increase
of 50% of over 60 years population
and 84% in over 75 between 2008
and 2033.
• Extrapolating from estimates of
growth in demand would mean
Scotland’s care budget for older
people growing from £4.5bn to
£5.6bn (2016), and £8bn (2031).
• Background is that there appears to
be a very large structural fiscal deficit
in Scotland over next 16 years.
Response
• Scottish Government developed a 10 year change
programme for ‘Reshaping Care for Older People’ –
promoting co-production and community capacity building
as a key work stream.
• Investment – to drive this programme, Scottish
Government created a four year Change Fund for older
people’s services of £70m p.a. as a catalyst.
• Coordination – to support this work stream, the Joint
Improvement Team provides support for 32 locally based
NHS, Council, Third and Independent Sector Partnerships.
Policy influences
 Sir Harry Burns (Chief Medical Officer for Scotland) – health and social care
based on ‘mutually beneficial partnerships between patients, their families
and those delivering healthcare services which respect individual needs and
values ...’ .
 Christie Commission – ‘unless Scotland embraces radical new collaborative
culture throughout our public services…budgets and provision will buckle
under the strain’.
The Governance International Co-Production Star
Governance International Co-Production Star
Training
• JIT commissioned Governance International to provide
three two-day training workshops in January, and a further
five in April.
• Participants came from LAs, NHS, Independent and Third
Sector Partnerships.
• Gave participants a clear understanding of what coproduction can achieve, how it is being used on the
ground, and how they can roll out co-production in their
organisation and partnerships.
http://www.govint.org/english/main-menu/our-services/co-production.html
National Community Capacity Building and Coproduction Conference, 26 January in Dunfermline
Nicola Sturgeon MSP, Cabinet Secretary for Health and Wellbeing
‘The Scottish Government is committed to supporting older people to
enjoy full and positive lives in their own homes, or a homely setting, within
their own communities, for as long as possible… the involvement of older
people and other members of these communities must be at the heart of
both shaping how this is achieved and of the renewed public services that
do and will support that achievement. Community capacity building and
co-production are central to these endeavours…’
Case Study 1: The Food Train
1) Objectives of co-production approach
Survey of older people in Dumfries -> struggling with grocery shopping.
2) Change management process
o
Partnership of local shops and volunteers began to make deliveries in Dumfries
Town in 1995.
o
From 2002, after 4 years of Scottish Government funding, national scaling-up:
o From 3,500 deliveries/year in 2002 and 60 customers by 11 volunteers to
15,000 deliveries/year to 596 customers by 200 volunteers in 2008/09
o Annual membership is £1, each grocery delivery is £2 and extra jobs range
from £1 - £2.
o
Alongside delivering groceries, the Food Train has responded to needs for
befriending and household support services to enable older people live in their
homes as long as possible.
Case Study 1: The Food Train
3)
•
•
•
•
•
Outcomes
Independence
Health
Isolation
Wellbeing
Safety
76%
50%
35%
27%
21%
“The ladies and gents are so polite and kind, I do look forward to seeing them. I
look forward to the happy visit even for such a short duration… It’s the
company, having a banter. I joke with the volunteers and they with me.”
[Lady, aged 80-89, lives alone] .
Source: Community Food and Health (Scotland). Evaluation of The Food Train in
terms of its Economic Value by Marion Lacey, ROCK SOLID SOCIAL RESEARCH LTD.
Case Study 2: Family Nurse Partnership in NHS
Lothian and Tayside
1) Objectives of the co-production approach
•
improve maternal health, child health and development, and
family economic self-sufficiency
•
focus on health inequalities, child poverty and early years
2) Change management process
•
Relationship between the family and the nurse is key with an
approach focusing on:
o the strengths of the client
o respect that they are the expert in their own life
o developing goals for the family
Case Study 2: Family Nurse Partnership in NHS
Lothian and Tayside
3) Outcomes
•
In Lothian and Tayside: 12 nurses and 3 supervisors will have
reached over 450 families by this summer
•
Strong evidence base for the model :
o Improved development and academic achievement
o Reduction in children’s injuries, neglect and abuse
o Improved parenting practices and behaviour
o Increased maternal employment and reduced welfare use
o US studies have suggested a return on investment of between
$2.8:1 and $4:1
(http://www.pueblochc.org/services/NurseFamilyInfo_Benefits.pdf)
Other good practice cases in Scotland
• West Edinburgh time bank
• Fife SHINE project on tailored
care packages for frail, elderly
people
• The Friday Night Initiative at
Pollok Library and Leisure
Centre in Glasgow
• Lend a Hand (Fife Social Work
Departments Child and Family
Team)
Co-Production good practice cases wanted from
Wales!
Governance International
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