Transcript Strengthening partnerships to improve alcohol services

Strengthening
partnerships to improve
alcohol services
East of England Regional Alcohol
Conference, 19th May 2010
Rachel Herring, School of Health and Social
Sciences, Middlesex University, London.
[email protected]
Policy context (New Labour)
 Alcohol a new priority compared to drugs
 Focus has been on:
o alcohol related crime and disorder
o public spaces
o youth (‘binge’ drinking)
o acute health harms e.g. accidents/injuries, hangovers etc
 More recently:
o Home drinking
o Middle-aged (middle class) hazardous/harmful drinkers
o Broader health harms e.g. heart disease, cancer, liver disease
NEW GOVERNMENT –NEW DIRECTION?
Policy context (New Labour):
Reducing alcohol-related harm
• Devolution of the responsibility to local areas for action
to address alcohol-related harm and help achieve
national targets.
• Use of partnerships as a mechanism for developing and
implementing local alcohol policies e.g. CSPs,
DA(A)Ts, PCTs, LSPs (and LAAs).
• High Impact Changes
• GORs have a supporting role.
• Alcohol as a cross cutting issue – health, criminal
justice, community safety, commerce.
Partnership
What is partnership?
“An agreement between two or more independent bodies
to work collectively to achieve an objective” (Audit
Commission , 1998, 2005)
Why work in partnership?
 Perceived failure of separately defined and run services
 International evidence: multi-component approach
 Funding
 Statutory requirement e.g. CSPs (formerly CDRPs)
A MULTI-COMPONENT APPROACH:
Co-ordinated Action
a programme of co-ordinated action based
on an integrative programme design
where singular interventions (or stand
alone projects) run in combination with
each other and / or sequenced together
over time.
THE WHOLE IS GREATER THAN THE SUM OF
THE PARTS
Alcohol partnerships require:
 Appreciation that alcohol is a complex, crosscutting issue that requires complex solutions
 Identification, mobilisation and co-ordination of
appropriate agencies, stakeholders and local
communities
 An understanding that the whole is greater than
the sum of the parts
 Change in professional behaviour
The whole is greater than the sum
of the parts:
 Agreed common overarching goal
 Understanding the ‘bigger picture’
 Planning and delivering interventions/services
that take account of the ‘bigger picture’
 Identify what each player contributes/gains from
participation in the partnership
High Impact Changes
 Work in partnership
 Develop activities to control the impact of alcohol
misuse in the community
 Influence change through advocacy
 Improve the effectiveness and capacity of specialist
treatment
 Appoint an Alcohol Health Worker
 IBA – provide more help to encourage people to drink
less
 Amplify national social marketing priorities
Alcohol partnership: a Vision
http://www.alcohollearningcentre.org.uk/
“to work effectively in partnerships, partners
must be agreed on a vision for the area. It is
not enough for a vision to simply record the
things that partners want less of …..Partners
should be able to describe what an area will
look like at the end of their endeavours so
that they can maximise the potential to work
collaboratively and reduce the risk of
becoming target-focussed and working in
silos.”
Factors that drive partnership
working
Individuals
Champions
Engagement of senior management
‘Buy in’ at all levels
Clarity: purpose, goals, roles
History of partnership working
Sharing information and best practice
Building in sustainability
Barriers to partnership working
Lack of engagement of senior management
Silos: working and thinking
Professional ‘tribes’
Inadequate resources: human and financial
Time pressures: ‘quick wins’ and workload
Complexity of the policy context
Non coterminous boundaries
Professional change
Professional tribalism
Reconfiguration of professional boundaries
Embedded identities can be disturbed by a
change in work ‘culture’
Fixed work ideals
Identity and belonging
Trust and responsibility.
Local communities
Knowing
Assessing
Engaging
Changing behaviours
Changing cultures
Early findings: achievements in past year
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Joint agreement on priorities and resource allocation
Getting alcohol on the agenda at CEO and LSP level
Alcohol as key priority for PCT strategic plan 2010/11
Alcohol embedded in joint commissioning groups
Development of county wide strategy
Development of new services e.g. IBA, AHW
Retendering of specialist services
Developing user voice in the development of services
Reduction in alcohol related admissions
Reduction in alcohol related crime
What would help partnerships?
FUNDING
STABILITY
TIME
A
COMPLEX
PROBLEM
ALCOHOL
Needs
Partnership
working
Needs
Multi-component
programme
approach
Key players
Health
Criminal justice
Education
Public
Trade & industry
Culture & media
Further reading
• Mistral, W., Velleman, R., Maastache, C. & Templeton, L. (2007)
UKCAPP: Evaluation of 3 UK Community Alcohol Prevention
Programmes. London: AERC. Available at:
http://www.aerc.org.uk/documents/pdfs/finalReports/AERC_
FinalReport_0039.pdf or summary
http://www.aerc.org.uk/insightPages/libraryIns0050.html
• Perkins, N., Smith, K., Hunter, D. et al (2010) ‘What counts is
what works’? New Labour and partnerships in public health.
Policy & Politics 38(1): 101-117.
• Thom, B. & Bayley, M. (2007) Multi-component programmes: An
approach to prevent and reduce alcohol-related harm. York: JRF
Available at : www.jrf.org.uk/publications/new-approachprevent-and-reduce-alcohol-related-harm