Building Collaborative Places: How to make system change real

Report from the North East Social Leader’s Network  meeting on 5th April 2017, by our Business Development Manager, Neil Shashoua with thanks for the photos to Carol Botten of VONNE (via Twitter).

The event

The Network hosted Dr Henry Kippin, Director of Collaborate launching, in the North of England, Collaborate’sBuilding Collaborative Places’ , a report that draws on a year of action research in Greater Manchester, the West Midlands and the South East. It offers system leaders a framework to reboot strategic partnerships and change the culture of collaboration across services to the public in a place.

Takeaway

Everyone talks about collaboration, system change, and asset-based approaches; often these words are used as part of rhetoric resulting in little actual change. The big systems that operate in planning, funding, and delivering public goods need changing; for at least two reasons:

  • Money to run them – the old social contract of an exchange of economic growth for the improvement of everyone’s living conditions, no longer operates. The gap between rich and poor; in our towns, cities, countries and the world, is increasing and a new politics of ‘permanent austerity’ is in the ascendency in this country.
  • Power – the shift in providing welfare services from the state to individuals and businesses means that we are all less confident in continuing to do things to people in which they have little or no say.

New principles for place based change include

  1. Stop thinking about public services and start thinking about services to the public – it’s not just about what local authorities, the NHS and other public bodies provide
  2. Collaboration by default should be our mode of thinking and acting
  3. The people who are the end users of the change get to define the scope/location of the change – top down grand plans tend to fail to bring about lasting change.

The activities that system change need to succeed are to do with setting up the conditions that make change possible. Collaborate have identified nine building blocks of infrastructure for local collaboration. A key insight from their research is that, in the main, the separate, silo infrastructure of each organisation in the system that needs to be changed tends to undermine collaboration, thereby fracturing the local system. Furthermore, the role of collaborative infrastructure to enable system change is often overlooked, misunderstood and underplayed.

Leaders need to lead by example; which is why leadership is hard. Thinking beyond the concerns and boundaries of the organisation you lead is a personal journey.

Why this is important to the Consortium

Here at the Consortium, we have a big vision around assisting our members to collaborate with each other and with commissioners and funders to improve the health, care and well being of people in Gateshead and Newcastle. Increasingly, the organisations and programmes with which we collaborate are pushing the system to change so that’s people who are already disadvantaged in our area are not disadvantaged further by the failure of the system to respond to their needs and that their response does not disadvantage those people further.

Collaborate’s analysis and tools are refreshing and inspiring. We think they are worth exploring to help us change the conversation (and therefore our approach and thinking) in how we assist our members and supporters to change the systems within which they operate and help their beneficiaries to improve their lives.

The full report

Q: Why is collaboration a lot like teenage sex?

A: Because everyone says they are doing it; everybody thinks everybody else is doing it. And the reality is that no-one’s doing much of it at all.

Dr Kippin’s opening joke led onto him talking about the language we use around system change; he finds it disheartening and challenged us to come up with different terms. In his view, collaboration, system change and asset-based are terms used a lot of the time, and a lot of the time these terms are used to sustain a system with very little change.

Whenever we think of system change we need to ask ‘for whom and on behalf of whom?’ In this way we can find out whether the collaboration that we talk about holds the weight of the work we do.

Where are we now?

Woody AllenThe current international scene as well as what’s going on in our towns and cities everyday feels like ‘the end of days’. We have a new politics of permanent austerity. There’s been a shift away from public management and the marketisation of public services has not led to better services nor got us out of the fix we are in. The cost of welfare is being deliberately shifted from the state to individuals and businesses. Not many of the models we have for service provision feel sustainable.

There is no point in trying to save public services as they were in Nye Bevan’s day when a bedpan dropped in hospital reverberated in the corridors of Whitehall. We’re not in that world (and perhaps we never were).

The gap between the demand for public services and the spend gap is estimated at £7bn. we can’t change the system by throwing money at it. Demand is more complex than that anyway because we (an ageing population) have all the characteristics and complexities that we do.

This is also where we start to question the growth model – it doesn’t make sense to keep thinking of our economy as growing and that services to the public will be funded from that growth. Our economy has undergone a structural change enabling an increasing gap between rich and poor in this country (and the world).

How we manage change – we know less than we think we do

Evaluations of big change programmes, such as Troubled Families, shows that however good the theory and however good the practice, the outcomes may still end up to be very poor.

The public’s experience of public services

This can be encapsulated by the Groucho Marx quote “I’ve had a perfectly wonderful evening. But this wasn’t it.” The public’s engagement with the state’s services to a level where they are influencing and controlling them is very low.

The welfare state now

If William Beveridge, architect of the welfare state, arrived in the North East now, what William Beveridgewould he find? If the five Giants of the post war Country which Beveridge addressed were want, disease, squalor, ignorance and idleness; what are the new Giants today?

On Dr Kippin’s list of new Giants are housing, domestic violence, loneliness, social isolation, mental ill health, and poor aspirations. They are all the drivers of pubic spending, poor service outcomes, and miserable lives of people who experience them. And none of them are the gift of any one organisation to solve.

But we have a vision gap for the future of public services because our current politics deals with very short-term phenomena. We need place based system change and Collaborates report makes the case for what place based change needs to happen and why it is important. Let’s start with principles for place based change.

Principles of a new model of place based changed

These might look different in different places.

principles of new modelFirstly a shift from public services to services to the public. We needs to stop thinking only about public services and instead to think about what people need to ensure they have access to the world eg a smartphone and wifi connection.

Secondly, trying to be collaborative by default – a lot of the dysfunction in our society is reinforced or created by failure demand created by the fragmentation of public services for mostly historical reasons. If we look at the Public Health England sponsored Commission for Health and Social Care Integration in the North East, it is less about public services and more about what it would take to get consultant doctors to live in Sunderland and how to reduce the high proportion of agency staff in our health & social care services. It very much echoes The Marmot Review into health inequalities in England about the world we want to see.

There are things we always need to do when thinking about system change

  1. Change the starting point of these conversations. Places mean different things to different people. Brexit told us that. Agencies usually start off having mapped out their focus for the location where they want to see flip the starting pointchange – rarely do they ask what does that mean for the people who live there.
    Similarly social support mean different things to different people. Researching into families under the Troubled Families programme showed that what positive change means for families can be different from what it means to professionals.
  2. Learn from practice – take this notion of collaboration seriously. It is nice to have a sense that you are working togpracticeether and the more you talk about sharing power and risk, the better it will work.

None of this happens by accident – there are some places doing it really well

  • Coventry – Ignite: VCS system led change
  • Oldham – innovative work around primary care, GPs doing less work for less income and bringing in people do to do other things to improve health
  • Sheffield Money; the City Council set up a rival to Wonga.
  • Suffolk – model for how community development, economic growth and public sector reform work together.

All of these things have one thing in common – that they are pushing against the grain. We don’t need more plans/more design. We need to focus on what are the conditions that need to be true for what we want to happen. We need to ask ourselves what needs to be true in order for this behaviour to change? When we are thing about system change it is about pre-conditions.

And when we talk about the conditions that need to be in place the change to happen, we are talking about infrastructure to underpinning those conditions. Infrastructure is about the rewiring that needs to be in place for change to happen.

Collaborate have boiled this down to nine building blocks to system change to create a way to have a diagnostic conversation about system change.

Building blocks

What does all this mean in terms of leadership?

Since this is the North East social leaders network, Dr Kippin wanted to pose the question of what does all of this mean for leaders. Increasingly he finds himself agreeing with the old adage ‘A fish rots form the head down’. Most transformations of big organsations fail- one prominent leader has estimated that 70% of them fail. Businesses fail to transform themselves because leading this agenda is a personal journey. Perhaps the nearer you are to the top, the harder it is to make that personal journey.

People in positions of responsibility and power need to take responsibility. CEOs of hospital Trusts need to think beyond the next CQC rating.

He gave as a good example of leadership Mick Cornett, the Mayor of Oklahoma City, who concerned that his city was too obese, found that he was too. His response was to go on a diet and took the city through his diet. His influence made a significant difference to obesity rates in Oklahoma. You can watch him talk about it here

Coming together to celebrate our achievements and look to the future

 

Our Annual General Meeting, Wednesday 16th November 2016 at Gateshead Advice Centre

Takeaway:

The Consortium achieved much last year: creating one consortium from two; building our infrastructure; continuing to deliver the Fulfilling Lives initiative; and winning funding from the Baring Foundation for a project involving our members. We also brought members together to help them bid, successfully, for a major project to help families in Newcastle in crisis.

Currently we are working with health, arts and culture organisations to develop Well Newcastle Gateshead, a pathfinder to improve the health of the poorest people fastest, in Gateshead and Newcastle.

The University of Northumbria’s survey of our members showed that our Consortium is diverse in the size of our membership and that members provide vital health, social, educational, economic and environmental services, which are increasingly in demand. They continue to face reductions in funding, find it challenging to secure grant income and some struggle to go for and win contracts to deliver the services they provided under a grant. They are uncertain as to the impact of Brexit and the halting of the North East devolution process. However, they have practical support and skills to offer each other.

Blue Stone Consortium’s first Annual General Meeting went off to a cracking start with a warm welcome from Alison Dunn, Chief Executive of Gateshead Advice Centre and a trustee of the Consortium, to the gathering of 30 members and supporters. Martin Gollan of Newcastle Council for Voluntary Service very ably took photos and tweeted for us throughout the meeting so we could share the experience with memebrs and supporters who could not make it to the meeting.

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Our Chair, Dave Woolley, set out BSC’s achievements last year, confirming that the Consortium now has 41 members, has grown and developed thanks to the support of those members and the financial investment made by Fulfilling Lives Newcastle Gateshead. He thanked Fulfilling Lives for awarding us the contract to deliver the client facing operation side of this innovative programme, which helps people with multiple and complex needs. Without this investment the Consortium would not have developed.

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We said goodbye to two Board members; Mike Halsey of Key Enterprises, standing down from the Board after putting in a lot of work to help establish the Consortium, and to Nancy Doyle who has moved on to be Chief Executive of Virgin Money Foundation. Dave thanked them both and we will stay in touch with them.

The meeting appointed Steve Nash (VOLSAG), Neil Board (Changing Lives) and David Smith (Oasis Aquila Housing) to the Board.

Finally, Dave presented the Consortium’s future plans, including

  1. Continuing to support the delivery of the Fulfilling Lives programme
  2. Delivering our Blue Stone Rights Project
  3. Pursuing the opportunities around Well Newcastle Gateshead
  4. Continuing to seek business opportunities that ensure the Consortium is sustainable in 2017/18 and beyond.
  5. Continuing work to develop a common vision for the Consortium’s work across Newcastle and Gateshead.
  6. Developing the Consortium’s offer so that it is as clear and focused as possible.

Neil Shashoua, our Business Development Manager informed the meeting that the Consortium’s income in 2015/16 was £431,173 and our expenditure was £422,043; leaving a healthy balance of £9,131.

Almost all of our income was from the Fulfilling Lives contract and 92% of spend was to the six member organisations that we contract with to deliver the programme, using only 8% of our income to run and develop the Consortium and manage the Fulfilling Lives contract. In 2016/17 we have other income streams and are less dependent on last year’s sole source of funding.

The Consortium’s new focus on health, care and wellbeing

Brendan Hill, Chief Executive of the Concern Group and one of our trustees, presented the Board’s thinking on the future focus of the Consortium. The population needs are rapidly evolving; the social determinants of health, how society provides support and care for the vulnerable and the urgent need to prioritise prevention, are all challenges that government and public services are facing.

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He noted that the voluntary and community sector and our members specifically already do, and increasingly will play an integral role in supporting individuals, communities and vulnerable groups to lead valued lives. As a result of this, the Consortium’s Board wishes to promote our potential as a key partner in developing solution-focused approaches from member organisations already involved across a broad spectrum of projects, initiatives and services supporting health, care and wellbeing

He proposed that this needs to be the primary focus of the Consortium going forward and he asked for the meeting’s views on this focus on two initial priorities based on soundings taken from the membership

  • young people and families
  • those with complex needs

both of these priorities include using intergenerational approaches for delivery.

The discussion that followed covered the important role Consortium members have in audience-5smldiverting people away from care and preventing them becoming ill or their condition deteriorating such that more intensive healthcare is needed.

Listening to our members

Dr Jan Myers from Northumbria University’s Business School then presented the findings of her survey of our members.

She noted that 55% of the membership responded and most of those responding were medium sized organisations. Overall, members provided a wide range of services to a wide range of people in Newcastle and Gateshead, with people with mental health problems, learning difficulties and carers being the top three categories.

jan-myers-tweet-1Members face a number of challenges; all but one experienced an increase in demands for its services over the last 12 months and most are dealing with reduced income whilst aiming to sustain their much needed services.

The level of income from grants has continued to reduce with more organisations reliant on contract income. Given that larger organisations have been in a better position to attract contracts than smaller ones, Dr Myers underlined the usefulness of having a consortium of small, medium and large organisations working together to secure resources to benefit people in the area.

Over half the respondents had no or less than 3 months reserves. Those with reserves anticipate using them to cover core costs and meet budget deficits.

Our members are uncertain as to the impact of Brexit and the halting of the North East devolution process. However, they have practical support and skills to offer each other.

Dr Myers will continue to work with the Consortium to better understand the needs of members and how members can support each other by exchanging skills and practical support.

The next three speakers illustrated ways in which they are working with the Consortium to improve the quality of life and wellbeing of disadvantaged people in Gateshead and Newcastle.

A single point of commissioning – Blue Stone Rights Project

Michael Fawole of the North East Law Centre talked about how his organisation is working with the Consortium to enhance the work of members by helping them introduce legal and human rights work.

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The project is a good example of how a funder can use the Consortium as a single point with which to work with a range of diverse providers.

With £28,600 of funding over two years from the Baring Foundation, the Consortium and Law Centre have set up a project to bring together nine of the Consortium’s members with the Law Centre to raise their awareness of legal and human rights approaches and help them to introduce and monitor the use of those approaches to improve the help they can give to their beneficiaries.

To date, the Law Centre has held workshops with Newcastle YMCA and Skills for People and has dates in the diary for workshops with Newcastle Carers, and Streetwise. Workshops with Children North East, the Angelou Centre, Involve North East, and Riverside Community Health Project are being arranged.

Brokering relationships and opportunities

Newcastle’s Help Through Crisis bid – how the Consortium helped bring together partners to win a bid.

In late 2015 the Consortium brought together a number of its members to develop a bid for the Big Lottery’s Help Through Crisis Fund, in Newcastle. Neil Baird of Changing Lives presented the useful role the Consortium played as an ‘honest broker’ to gather members to explore developingneil-baird-tweet-1 a bid to this fund, which is  aimed at people facing hardship. In the end, three of the organisations went on to bid successfully for £500,000 over 5 years to deliver a project to provide tailored support, advice and advocacy to enable families to address difficulties and be in a better position to improve circumstances and plan for their future.

The partnership, led by Newcastle Law Centre, has contracted with the Consortium to be the independent chair of the project steering group, to give all partners an equal voice in the governance of the project.

Can the Consortium help communities create, connect, and aspire to improve the health of the poorest, fastest?

Professor Chris Drinkwater, Chair of Ways to Wellness and long term champion for reducing health inequalities, presented the meeting with an exciting initiative with the Consortium to improve the health of people in some of our most deprived areas in Newcastle and Gateshead.

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He is working with Well North, an initiative to develop pathfinders in some of the poorest parts of the North of England, to develop the next pathfinder in Newcastle Gateshead. The Consortium’s Board has set up a committee to lead the development of Well Newcastle Gateshead, focussing on improving the health of people in four parts of the area, majoring on work with

  • children 2 to 7, their parents and grandparents
  • adults, to improve their mental health and be more socially connected

by using arts, heritage and culture to help people have fun by using their creativity, connecting them together, and helping them aspire to be more active and healthy.

If the Well North Board accepts the proposal, they will release £1m over four years, matched by £200,000 from each of Gateshead and Newcastle local authorities. Arts and place-based voluntary, community and social enterprise organisations would deliver much of this work.

After questions to the speakers, it was over to the participants to discuss

  • how could they make use of the Consortium in the next 12 months
  • their thoughts on the Consortium’s new area of focus and where they see themselves contributing and benefitting from it.

It was clear from the discussions that members and supporters want

  • Help to identify business opportunities
  • Linking in with existing Consortium initiatives, such as Well Newcastle Gateshead
  • More communications with funders to help providers reduce/avoid duplication and to bring members and funders together
  • Connections with national and strategic bodies
  • Greater focus on asset based approaches that are genuinely people led

There was also support for the Consortium’s new focus on health, care and wellbeing.

The meeting ended with tea and cake provided by the lovely people at Gateshead Advice Centre.

Thank you!