Embedding arts and culture within Community Mental

Health and Wellbeing ServiceEmma HansonHead of Strategic Commissioning - Adult Social CareVicky Tovey Commissioning Manager - Public HealthLaura Bailey Arts & Regeneration Officer – Economic Development

Arts & Culture in Kent

• Kent boasts a high profile and vibrant cultural sector

• Arts & Culture Service re-positioned within Economic Development as a strategic service

• Financial pressures led to need for diversifying business models and innovation

• Track record of arts organisations to be able to deliver wider outcomes

• Excellent art is at the heart of what we do

Partnerships & Shared Aims

• Public Health moved back to the Local Authority• Looking for innovative ways to engage people and improve

health and wellbeing• Kent’s mental wellbeing programme provided an opportunity

and funding to try something new • Co-investment and design with Artswork and Royal Opera

House Bridge• Six Ways to Wellbeing pilot• Arts & Cultural Commissioning toolkit

Public Health Six Ways To Wellbeing Pilot Six creative organisations commissioned to deliver health outcomes, develop learning oncultural commissioning

Which led to development of artscommissioningtoolkit.com

Partnerships & Shared Aims

Cultural Commissioning Programme

Successful CCP bid due to:

• Commitment to embedding arts in public service delivery• KCC plans to become strategic commissioning authority• Public Health, Adult Social Care and Policy backing• Proven track record of work between arts and health and wellbeing

What we did:

• Developed Theory of Change• Brought Early Help and Waste Management on board• Decided to focus on a live tender mental health & wellbeing

Organisational Change & Buy-in

New Economics Foundation support helped with:

• Coaching and mentorship • Culture change .. specifically highlighted in new

strategic statement and outcomes framework• Director and Member support• Buy in from additional services

Kent residents enjoy a good quality of life, and more people benefit from greater social, cultural and sporting opportunities

Organisational Change & Buy-in

There is a duty to promote well-being

The Care Act:• Places well-being at its heart: the

primary responsibility of local authorities is the promotion of the individual wellbeing of both those with care needs and carers

• Shifts responsibility from providing services to meeting needs

• Focuses on the need for services to be preventative, and stresses the importance of using the existing strengths and assets of individuals and communities an assets based approach

A Life not a Service !

What does a good life look like for you and your family and how

can we work together to achieve it?

Underpinned by Six Ways to Wellbeing

• Public Health; universal services that support prevention, emotional health and wellbeing.

• Adult Social Care; day opportunities, employment services and service user engagement

• Clinical Commissioning Groups; commissioned; secondary and acute mental health services, improving access to psychological therapies

• Supporting People; housing related support specialist housing schemes

Historically services worked in silos focussing on particular issues or steps in a journey. New integrated and outcome focussed approach aligned budgets to create Maximum bang for our bucks !

Integrated Commissioning

Profile of Investment

NB* does not include Primary, General Hospital or Continuing Health Care Spend

4.9 7.4

9.4

101m

8.5 3

Joint Funded Community and Voluntary Sector Care KCC Funded Residential Care KCC staff seconded to KMPTCCG Adult Mental Health Commissioned Services Improving Access to Psycho-logical TherapiesHousing Schemes and Hous-ing Support

12

Information advice and guidance

Emotional wellbeing

Social Inclusion and supportive

community networks

Self management and support to maintain

recovery

Employment support

Advocacy

Carers Support

Primary care support

Peer brokerage

Reshape market and develop Circles of

Support model with no wrong door

Current model confusing array that you have to navigate

for yourself

Person

Information advice and guidance

Emotional wellbeing

Social inclusion and supportive

community networks

Self management and support to maintain

recovery

Money advice

Advocacy

Carers Support

Employment Support

The Vision - Person Centred Community Based Services

Person

Outcomes that matter most to people….

• Be connect to their communities and feel less lonely and socially isolated

• Have choice, control, and feel empowered • Live safely and independently in stable

accommodation and manage their life • Stay in or enter employment • Ensure income is maximised, debts are managed and

where appropriate applicable welfare benefits are accessed

• Be involved in service design, service offer and availability

• Be appropriately supported to manage their recovery

Outcomes that matter most to the system …

• Reduce the number of people entering hospital in crisis and residential care admissions

• Reduce the numbers entering secondary mental health care

• Increase the numbers of people being transferred from secondary services to primary care

• Increase number of people self-caring following a period of enablement through the short term recovery service

• Reduce suicides

• Community First• Person Centred• Value Driven• Outcome Focussed • People are connected to their community and people

who have had the same experiences • People are empowered and supported to get what

they need/want - Community Link Workers • People only go into secondary services when 100%

necessary and can be discharged ASAP continue and maintain their recovery in a primary care setting

A Life not a Service !

• Total pot 4m per year, historic funding re-profiled based on need

• 5 year contract with a 2 year extension clause • Let in 4 lots, mirroring CCG areas, max of 3

areas per single provider• Outcomes focused contract but with specified

requirements around employment, housing, link workers (CCG’s services e.g. IAPT)

• Co-location of Primary Care Social Care staff

Key facts for the procurement

…… is a public-sector tendering option that allows for bidders to develop proposals in response to a client's outline requirements. Only when their proposals are developed to sufficient detail are tenderers invited to submit competitive bids ….

Competitive Dialogue

Business Case developed

Stakeholder and Market Engagement – outcomes

and models

Publish OJEU Notice

Issue PQQ and invitation to submit outline

solution & bidders workshop

PQQ and ISOS received and evaluated

Shortlist for competitive dialogue – SP’s

Development of DP Matrix & engagement on Spec

Issue invitation to participate in dialogue

Begin dialogue

Range of themed meetings regarding Spec, pay mechs, T&Cs, TUPE

etc

Close dialogue

Invite bidders to submit final solution

Select bidders and award contract & mobilisation

…..

Customer involvement & co production throughout

Insight gathering

Insight gathering -

& coproduction

Service user

questions

Service user evaluation

Service user mobilisation group

• Proactive communication to sector - Tailored & targeted messages inviting A&C to events & making them aware of the opportunity

• Proactive messages from Commissioners - At market engagement events - set expectation

• Delivery Network Matrix - Potential Delivery Partners registered interest inc Arts & Culture

• Specification – Specifically listed Arts and Culture• Dialogue – Session on delivery network/A& C offer• Outcomes Performance Tracker - A&C KPI’s

Embedding arts during the process

Pro’s

• Really helps shape construction of service

• Allows for provider perspective

• Enables commissioners to understand from providers point of view

• Ensures service commissioned in best possible for outcomes

Con’s

• Labour intensive and costly for LA and providers - especially those who are not successful

• Repetitive Process• Slow Process

Pro’s and Con’s of Approach

• Two Strategic Partners;– Porchlight – Shaw Trust

• A diverse range of Delivery Partners over 60 with 15 from Arts and Cultural Sector

• Mix of funding arrangements – contracts, spot purchasing and grants

• 40K innovation fund, to seed fund good ideas • Flexible network that will develop over time

Outcome – Live Well Kent

Co-produced KPI’s and data set to track progress and measure impactSystems Outcomes• Using NHS numbers to track outcomes• In order to evidence impact on Acute Mental Health PBR

clusters Personal Outcomes• SWEMWB (Short, Warwick, Edinburgh Mental Wellbeing Scale)• Wider Wellbeing scales to show personal journey .. Self

selected/reported and person centred • 6 and 12 month follow upsNetwork Feedback – Merlin Standard compliance

Evaluation – Live Well Kent

New Model – Live Well Kent

• Ongoing work to develop A&C Offer• Establishing role of KCC A&C Service with Strategic

Partners and Delivery Network• Supportive and proportionate contract management• Flexible delivery network that will change over time

to meet needs• Continue to build on learning & evaluate impact • Support innovation, continuous improvement and

wider collaboration.

Next steps ….

• Shared vision is necessary and senior buy in a MUST • Not all A&C orgs ready for commissioning• Not all commissioners understand the value of A&C

in delivering outcomes• Procurement processes can be challenging• A&C deliver ‘added value’ evaluation is complex –

hearts and minds as important as evidence ! • This takes time and we need to develop more

partnerships in and out of A&C sector• Culture change needed on both sides

Learning to date …..

Thank you any …

Questions, Comments and / or Thoughts ….

We have found some amazing local groups that offer a rich and innovative approach who are not

constrained by funding in the same way as historically funded organisations and therefore able to adapt to new ideas and ways

of working … Shaw Trust