YOUR CONNECTED CARE CONTACT:

Gemma Bruce Head of Research, Community Engagement & Co-production

gemma.bruce@turning-point.co.uk

ConneCted CareDoing things differently

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Co-production

Turning Point is one of the UK’s leading health

and social care organisations. We’ve been

running public services in communities across

the country for almost 50 years. Our Connected

Care model offers a way of working that

enables commissioners to engage with their

local communities, and use the insight gained to

develop better services, jointly with them.

We think it is time for this kind of co-production

to become the rule and not the exception.

Engaging successfully with local populations

becomes more important every day. The changing

public health landscape means new bodies with

new responsibilities. The idea of “community

engagement” matters in this new landscape even

more than ever. For instance, the requirement

placed upon Clinical Commissioning Groups

(CCGs) is to put ideas of co-production of services

and community engagement at the heart of

their work. We all aspire to better public services.

Turning Point’s Connected Care model is a proven

and evidence-based method for improving service

design. And that inevitably leads to better services

too.

Where in the changing landscape are

you?

Would some signposting from an

established partner help you?

Let’s talk.

Turning Point’s Connected Care model works with commissioners and

communities to co-design health and social care services. Since 2004, the

Connected Care team have delivered community engagement and service

design and set up new services - commissioned by local authorities, the NHS

and most recently CCGs - across the country

“I want co-production between

commissioners and communities in

health and social care to become the

rule and not the exception. If this is

realised then it could have a profound

impact on people’s lives by improving

the way services are delivered. I believe

our Connected Care model is the vehicle

to enable sustainable co-production.”

Lord Victor Adebowale

Chief Executive Turning Point

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• Understanding the needs of the community?

• Integrating health and social care?

• Supporting patients with a long term

condition to better self manage?

• Moving patients out of hospital into the

community?

Connected Care is Turning Point’s unique

methodology for bringing about changes in the

design and delivery of health, housing and social

care services. This is about finding efficiencies in

the system – crucial when budgets are so tight.

We’ll help you rethink the way services work

together to support a combination of needs, and

look for ways to form an equal partnership with

communities in the design and delivery of public

services.

Connected Care is a bespoke service. We’ll

work with local commissioners to help define

the problem, and provide tailor-made solutions.

But there are four stages that are central to

understanding the method:

1. A community-led needs assessment

is conducted by trained community

representatives. These Community Researchers

drive engagement in every section of the local

community through rigorous research.

2. This research leads to recommendations

based on a strict cost benefit analysis. These

are reviewed by a local steering group made

up of local authority, NHS, third sector and

community representatives.

3. Service redesign or reconfiguration delivers

new levels of efficiency – focusing on service

integration and meeting the needs of service

users and commissioners alike.

4. Set-up of new services co-produced by the

community.

Blueprint

What’s your challenge?

When we describe our intervention as “bespoke”,

what do we mean? Some examples might help

you see how applicable the Connected Care

blueprint is to your local area. In Warrington we

focused on neighbourhoods experiencing high

levels of health inequalities, helping to inform the

Council’s planning and improving engagement

with the town’s most vulnerable residents. In

the Gorleston area of Great Yarmouth we found

solutions that helped to reduce emergency

inpatient admissions. In Hammersmith and Fulham

we launched a Community Champions scheme,

providing community-based support across a

wide range of services. The initiatives may be different but the method and outcome is the same: services produced in partnership are services that deliver.

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Connected Care offers a flexible yet robust

model for service development and delivery.

Connected Care does things differently: it

accepts that a “top down” model of service

development doesn’t meet individual needs,

and that some existing care provision is in fact

very “disconnected” with individuals that need

our support falling down between the gaps of

disjointed systems and services.

Instead, the Connected Care methodology

fundamentally shifts the balance of power

towards local people, allowing communities a key

role in designing joined-up health and wellbeing

services that meet those local needs. And by doing

so, Connected Care drives delivery of improved

outcomes.

A new way of thinking. A new way of doing.

Turning Point, an established sector partner, can

guide you through the process.

• Our “needs audit” engages whole

communities including “hard to reach”

audiences with targeted research

• Our recommendations are bespoke to your

community and operational setup

• We can provide change management support

to help you move towards the chosen

improved operation

• We seek optimum efficiency by reducing

duplication, maximising use of resources, and

enabling the community to play a bigger part

in service provision

Voice of the community

“Connected Care is a model for

commissioning that puts the voice and

needs of the community to the fore.”

‘A Vision for Adult Social Care’

Department of Health, 2010

In the last 12 months Connected Care has

made a difference in communities as diverse as

Gorleston in Norfolk and the London Borough of

Kensington and Chelsea. And in these and many

more examples we’ve helped put the voice of the

community at the centre of decision-making - to

the benefit of communities and commissioners

too. This works. But the model continually evolves

as need changes. Most recently we have adapted

the model to better support CCGs and worked to

develop a payment by results model in Barnsley.

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Changing landscape

The changing health and social care landscape

means that new bodies such as Clinical

Commissioning Groups and Health and Wellbeing

Boards are coming into being. There are some

central planks of thinking behind the development

of these new bodies, for instance

• community engagement

• placing a priority on understanding local needs

• providing services based on those needs

that build on the views of patients and

communities

The new CCGs are required to demonstrate

that they have a robust engagement process to

underpin decision-making. Engagement is no longer “nice to have”. It’s essential.

The adaptability of the Connected Care model

means we can focus our efforts to research local

communities, and develop new services, in ways

that suit your situation. Where is your biggest

area of concern? Managing long-term conditions?

Reducing the need for acute services? Integrating

health and social care? Then that’s how we’ll

direct our energy.

Shrinking budgets, increasing expectations

Connected Care develops bespoke solutions, and

works with you to create a financial model for

your project that works for all sides. We’ve got

confidence in the work that we do. At a time when

the budget reality is as tough as ever, our payment

by results model answers many commissioners’

biggest concerns right from the start.

The ‘Benefits Realisation’ report published by

Turning Point (see p. 11) identified that integration

of health and social care can create efficiency

savings of £2.65 for every £1 spent.

Democratic deficit

Involving communities isn’t easy. Creating

opportunities and shifting expectations away

from local authority delivery and towards a model

where services are co-produced with communities

– again, not easy. But the prize is a big one, and worth striving towards.

On grounds of cost and service effectiveness,

Connected Care works. The flexibility of the

model allows you to define the goal. Many of

the commissioners we work with talk about

“democratic deficit” – the gap between their

desire to talk to every section of the community,

and the challenges in doing so. Let us bridge that

gap.

For instance, in Kent we conducted research

into the needs of people from Eastern

European communities with drug and alcohol

issues. Interviews were conducted with local

stakeholders and service providers and a set of

recommendations developed for future service

provision. What’s your local issue? How can we

step in to help?

Meeting your agenda

Connected Care isn’t the solution to every commissioning problem. But it does

solve many of the common headaches that commissioners face. Here are a few

of them.

Strategic

planning

Comm

issi

onin

gReview

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Community-led Commissioning

CommunityEngagement

The commissioning cycle should and can involve the community at every stage.

Connected Care provides a method for doing that.

“Working with Turning Point...has reinforced for me the value of starting with the patient’s

lived experience when you are looking to redesign care pathways. As a result of this work

we have come up with some very concrete proposals which will help us deliver tough QIPP

targets. The project is a great piece of evidence for the (CCG) authorisation process but

more importantly the legacy is a fantastic group of community advocates who we can

continue to work with.”

Andy Evans

Chief Executive, HealthEast, Great Yarmouth and Waveney Clinical Commissioning Group

Needs assessmentService

reviewPriority setting

Service

design

Procurement

Implementation

Evaluation

Performance management

Monitoring

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Turning Point provides a valuable external viewpoint.

• We’ll help you develop better partnerships

with other local organisations

• We’ll help you evaluate what works and what

doesn’t

• We’ll propose joined-up solutions, and help

you develop future opportunities whilst

continuing to meet day-to-day targets

• We take “community engagement” from

theory into practice, enabling you to involve

the community in decisions across the full

gamut of public services

A shared vision

Local commissioning partnerships can create a

shared vision of improvement. Connected Care

can assist at any stage of the commissioning cycle.

Are we aligned? If so, let’s talk.

Let’s work together:

• to gain a broad range of patient and

community viewpoints – and then analyse and

act on the insight gained

• to innovate and find bespoke ways to deliver

against tough targets

• to challenge preconceptions and address the

root causes of the issues that hamper effective

service delivery

• to build on existing patient and public

involvement mechanisms, and engage with

whole communities including “hard to hear”

groups

• to redesign care pathways for specific patient

groups

• to integrate and streamline service provision

across public, private and voluntary sector

providers

Do you share our vision? We want to build

community capacity. We want to stimulate

innovative new models of service delivery. We

want to help you redesign care pathways. And we

believe Connected Care provides a starting point

for this kind of development.

Connected Care: doing things differently

Do you want to move beyond ideas and into action? Get in touch with Turning Point’s Connected Care team today:

Gemma Brucegemma.bruce@turning-point.co.uk

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Local champions

Our community engagement is led by members

of the local community trained by Turning Point.

They have direct experience of using local services

and are committed to making things better for

their local communities.

Simply by participating in Connected Care

research, our Community Researchers come to

understand and appreciate the full variety of

needs that the community has. They bring all

that knowledge to the task of helping shape

future provision. Typically they become staunch

advocates for the services they’ve helped to

develop, and create a long-lasting profile within

their community, helping to signpost services long

after the research role is complete. Often they

become your local champions, helping to create

visibility for the full range of your public services

– including your health and social care agenda

- well into the future. More than half of our

community researchers have gone onto to new

education, training or employment opportunities

as a result of their involvement with Connected

Care projects.

Connected Care builds more resilient

communities. It creates new social capital, builds

stronger and more supportive neighbourhoods

and develops confidence and networks in the

community. Our work has developed sustained

and lasting mechanisms for collaboration and

engagement between commissioners and local

people, including decisions on commissioning of

services. We have also supported the set up of

community- led social enterprises in local areas.

Most crucially, Connected Care has enhanced

local service provision by improving local services

and awareness of and satisfaction with health and

social care services in the community.

These local champions:

• Are “experts by experience” - they are

embedded at the heart of their communities,

so they know the issues involved

• Have excellent reach, getting to isolated

sections of the community, and turning the

ideas of the “hard to hear” up to full volume

• Bring credibility to the project through

personal experience of using services

We provide full support and training for our

Community Researchers, and enable them to

share and build knowledge and skills as part of a

national Community Leadership Network.

Experts by experience

“I was happy to become a community

researcher, as I felt, through my

experiences of life, I could understand

some of the problems people come

across and help resolve them.”

Gill

Community Researcher, Warrington

“By talking to people, I have been able

to open their minds to what they could

do by getting involved.”

Les

Community Researcher, Brandon

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In Practice

ProBLeM

Gorleston in Norfolk has an ageing population, a high proportion of people

living with a long term condition, high use of A&E, high levels of unplanned

emergency admissions and low uptake of community based services. The Great

Yarmouth and Waveney CCG, wanted help to reduce ‘heat in the system’.

Stimulating new solutions: Connected Care in practice in Norfolk

SoLUtIon Step 1

The CCG commissioned the Connected Care team

to engage the local community in the redesign of

care pathways. We recruited a team of community

researchers to undertake research in the local

community. Each researcher brought their own

experience of living with a long-term condition to

the project.

Over a period of 8 months, hundreds of

people from the local community, as well as

commissioners and providers of a range of local

services, engaged with the project.

SoLUtIon Step 2

The research uncovered significant gaps in

perception between professionals and patients

over service issues including treatment delays,

the purpose of A&E services, and the extent to

which patients were managing their conditions

successfully. It became clear that some new but

comparatively simple interventions, such as better

training of care home staff, could significantly

reduce the level of emergency A&E admissions.

A process of service redesign was set in motion,

building on the lessons learnt. Cost-efficiency was

certainly one of the desired outcomes. But at the

heart of the project was the intention to better

support self-management, and to provide better

experiences and outcomes for patients.

todaY

The project has resulted in the redesign of the care

pathway including the development of team of

lead GPs on long-term conditions, involvement of

community matrons in A&E assessments and the set

up of a user-led ‘navigator’ service based out of GP

surgeries which is a joint initiative between the CCG,

the Borough Council, the County Council, and the

local community voluntary sector. Feedback from

researchers, the CCG, and most importantly patients,

all suggest the project has given a new dynamism

to efforts to improve care services in the Great

Yarmouth area. The redesigned care pathway is being

independently evaluated.

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Turning Point

Working with turning Point: Sustainable, bespoke solutions in health and social care

The Connected Care model works. Since its

inception in 2004, Turning Point has successfully

delivered projects across the country, engaging

with thousands of people in local communities

and giving them the kind of voice in service

development that has not been seen before.

Our way of working builds on all the knowledge

we have gained over almost fifty years as an

organisation that supports individuals with

complex health and social care needs. Our model

is evidence based and has been independently

evaluated by the University of Durham. It has

championed partnership and collaborative

working across health and social care at a

strategic level, developed more integrated and

joined up working, and involved front line staff

in developing a vision for more integrated service

provision. In addition, Connected Care has

developed sustained and lasting mechanisms

for collaboration and engagement between

commissioners and local people, including

decisions on commissioning of services. We have

also supported the set up of community-led social

enterprises to take on the delivery of local services.

We believe communities are too often

“disconnected” from the services that are

provided for them. Connected Care remedies that

situation. At a time when the health and social

care landscape is changing, community research

of the kind that is central to the Connected Care

method can become one of the new pillars of

service provision.

Connected Care isn’t just about ticking the

box marked “community engagement” when

setting up a new Clinical Commissioning Group –

although it certainly does that. By getting to the

heart of your local community our researchers tap

into hidden ideas, and uncover the roots of some

deep-seated problems. Through Connected Care,

we bridge the divide between commissioners

and communities, developing bespoke health

and social care recommendations that offer real

sustainable support to communities.

The Connected Care methodology has been

rigorously developed to the highest management

standards, and validated against industry

benchmarks.

• High quality quantitative and qualitative

research methods, adapted for each project

• Our training programme is quality assured by

the Social Care Institute for Excellence

• Our researchers ensure the community

engagement programme fits the local context

• We ensure our sample is representative of

local demographics

• Using our knowledge of supporting people

with complex needs to engage “hard to

reach” groups

As a social enterprise, Turning Point has extensive

knowledge of delivering to target within multi-

stakeholder environments. You benefit from our

• Robust project and risk management systems

• Service design expertise

• Knowledge of the latest innovations in service

delivery models

• Ability to set-up new community-led

enterprises to take on delivery of local

authority functions

How can Turning Point help you?

Let’s talk.

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Resources

Connected Care Impact Report

Over the past eight years, Turning

Point’s Connected Care model has

supported a wide range of communities

to design and deliver health and

wellbeing services in their areas. This report reviews

the impact of Connected Care’s work to date

and shares our learning on co-production with

leading commissioners, decision makers and the

communities that we have worked with.

The Impact Report is available in “full” and

“summary” versions.

Benefits Realisation

A systematic review of the

economic evaluation evidence for

integrated health and social care

services.

Citizen Advisors: Linking Services and Empowering Communities

A survey of different navigator

models across the UK.

A number of resources are available on our website

www.turning-point.co.uk

For these and additional resources, please contact us or visit our website, and go to:

Community Commissioning > Connected Care > Resources

Turning Point

We turn lives around every day, by putting the individual at the heart of what we do.

Inspired by those we work with, together we help people build a better life.

Turning Point is a leading UK health and social care organisation. We provide services for people with complex needs, including those affected by drug and alcohol misuse, mental health problems and those with a learning disability.

Turning PointStandon House, 21 Mansell Street, London E1 8AA

Tel: 020 7481 7600

Fax: 020 7702 1456

For more information please visit our website at www.turning-point.co.uk

Turning Point is a registered charity, no. 234887, a registered social landlord and a company limited by guarantee no. 793558 (England & Wales). Registered Office: Standon House, 21 Mansell Street, London E1 8AA.