Transcript Slide 1
A Sure Start LAA Pilot for
Older People
Brighton and Hove City Council
Sure Start for Older People
in Brighton and Hove
• A new range of local services, opportunities and
choices for older people and their carers
• Two pilot neighbourhoods – 8,000 older residents
• Brighton and Hove Council, Primary Care Trust, Age
Concern, Older People’s Council, the Pensioners
Forum, the Pensions Service, Neighbourhood
Renewal and a range of voluntary sector partners
• A ‘Sure Start’ approach : universal & additional,
whole systems approach, enhanced services and
opportunities, built on participation and new forms
of governance
• Roll-out practice across city and lessons for
adult/other service areas
Why?
• Older people themselves know what they want and
need, they’ve told us and should be listened to
• We have to do better – current services not coping in
face of demographic challenge, embedded inequality
and pressures on commissioners & providers
• National drive for shift of thinking and investment –
need to demonstrate effectiveness (for service
commissioners as well as older people themselves)
of local solutions and practical ‘low level’ services
Principles - How
• Universal but targeted on ‘emerging needs’
• Increasing information, choice and opportunity and
meeting needs that people identify as most
important
• Older people’s voices & involvement – devolved
decision making & governance (c/f locality/G.P.
commissioning)
• Older people themselves as workers, contact points
and ambassadors
Principles - How
• Whole systems – beyond health and social care
• Through existing community networks and groups –
community development, volunteers and building
local capacity
• A ring fence for prevention
• Building a sustainability strategy
• Potential to devolve programme design &
commissioning to locality level – resourcing
participation and community governance
Strategic Aims
• To enable older people to live healthy,
independent and fulfilled lives
• To demonstrate the effectiveness of new
approaches to a more flexible, user led
service
Outcome and Action
• Improve information and choice for older people
enabling them to speedily access the services
they need and identify as most important
• Recruit, train and support volunteers (especially
older volunteers) as ‘new front line’ for
information, service access, healthy lifestyle
advice, promoting ‘independence’ options etc.
Self assessment pilot
Outcome and Action
• Improve the health and well being of older
people and reduce premature mortality rates
and inequalities in rates (focus on key risk
factors – heart disease, strokes & related
diseases, smoking, diet, physical activity)
• Range of primary health services available at
local level – dietetics, active for life, chiropody,
health checks, ‘health trainers’ programme,
health service ‘navigators’
Outcome and Action
• Reduce the number of people admitted to
hospital as a result of a fall
• Recruitment of falls prevention advisors to
local teams in each area – exercise
groups, health promotion, education , staff
and volunteer training
Outcome and Action
• Better supporting the contribution of carers
and maximising their own quality of life (to
include focus on older people who are
themselves carers)
• Partnership with Carers Centre to identify
hidden carers, develop local support
responses and offer enhanced casework
support service in localities
Outcome and Action
• Improve older people’s access to homes of good
quality suited to their needs, wishes and
changing life circumstances and to promote their
confidence and safety in the wider community
• East Sussex Fire and Rescue Service
partnership with newly commissioned
HomeWatch service– home safety and security
audits, improvements and adaptations service,
energy efficiency advice and grants
information/advocacy, fuel debt support
Outcome and Action
• Promote and extend access to and take up of
opportunities for education, employment and
occupation for those who wish to work, learn and
volunteer
• Partnership with Adult Learning Team – outreach
workers in each area re. education and
employment opps. for 50+, ‘return to work’
programmes, co-ordination of local learning
provision through range of providers
Outcome and Action
• Improve utilisation of services &
opportunities to maximise income and
access to relevant benefits, grants and other
financial support
• partnerships with Pensions Service and welfare
benefits team – outreach and home service for
pensions and benefits M.O.T. , advocacy, debt
management. Capacity building in local teams.
What else?
• Fund for local services and solutions
• Inter-generational projects
• Promoting and celebrating older people in
local communities
• Hard to reach – positive action plan
• Influencing re-design of services and ‘vision’
for commissioning older people’s services
• Gathering evidence as to ‘what works’ for
older people (and re-interpreting that to
professionals)
The Core
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Team Leader
Volunteering programme
Community development
Building local teams with local identity
Integrating with Neighbourhood Renewal and
working through community organisations
and existing infrastructure
• Capacity building and developing new
governance structures
Delivery on a shoe string
• £185,000
• Partner contributions – staff, expertise,
training, additional capacity
• Bending resources – Community
Development Commissioning,
Neighbourhood Renewal, Equal programme,
health trainers programme, LPSA, carers
grant etc
• Local priorities and realistic delivery against
national targets
Using the LAA framework
• Is LAA just a new set of funding and reporting
arrangements
• A planning tool
• A ring fence for prevention and lever for service
transformation?
• Prompts creative contributions and collaboration,
firms up partnership
• Vehicle for setting out strategic partnership’s
business agenda
• Potential to influence mainstream
• Improved GO/local relationships
But…..
• It’s tiny (ASC spend re. older people £28 million +)
• LAA and this approach not yet centre stage
• Changing cultures and intransigence of big
organisations
• Prevention loses out to acute priorities
• You have to work twice as hard to convince others of
the value of innovation
• Too early to tell on outcomes – realistic timescales
• “A shift in the centre of gravity of spending” ?