Case study: Commission services simply and collaboratively so they are ‘local by default’
More

Rebekah Sutcliffe

Rebekah is the Strategic Director of Reform for Oldham Council driving system change across the borough.

The Oldham Model

Reform in Oldham – making a real difference to local lives – building thriving communities, developing cooperative services and working towards an inclusive economy. In this case study, we outline how we’ve fundamentally rethought the way we interact with communities and place. In this spirit, we outline how our social prescribing innovation partnership has provided flexibility to work and coproduce with partners and residents and lay out some of its early impacts.

In Oldham we are looking at how we work differently and drive innovation in our approach to reform. We’re connecting people and place to services in a new way which works to empower communities through a strength-based approach – by that I mean recognising what we have and where we are strong, then building out from there rather than starting from a deficit based model of what is missing.

Oldham is a place I grew up in and has a strong history of working together to overcome past challenges and one where everyone is encouraged to do #yourbit towards creating a confident and prosperous town to live and work, and one where we are putting social value at the heart of our agenda.

 

The Oldham Model is the bedrock of our approach. It’s already making a real difference to local lives. It has three interdependent goals. Firstly, we are working to build Thriving Communities that are resilient with strong community ethos, people and groups who are supported through community development to help each other. Secondly, we underpin this with our Co-operative Services work, which is focused on all partners (public, private and voluntary) working more closely together. That in turn is helping us to work towards our third goal of an Inclusive Economy.

We have committed to be a Living Wage Foundation employer and, along with our partners, to invest more in Oldham and provide greater employment opportunities for people who live here.

To achieve sustainable change, we know we have to fundamentally rethink:

  • the way the public sector operates, its relationship with communities and place
  • how we work with individuals and families
  • how we interact with people and community to develop community connectedness, and build confidence
  • how we take a strengths-based approach and have potentially different conversations that start with the positive and what we can build on
  • how we operate as a ‘system’ to unblock the barriers and system conditions that prevent people being able to make good choices and to live good lives.

Our Thriving Communities programme helps achieve this through our social prescribing work.

In March 2019 we marked the world’s first Social Prescribing Day by commissioning a pioneering three-year Innovation Partnership on behalf of Oldham Cares (our integrated care organisation) to a local consortium of voluntary and community organisations to build upon the Social Prescribing network.

This Innovation Partnership – a contracting approach available to commissioners since 2015, enabling the development and subsequent purchase of a new, innovative product, service or works without the need for a separate procurement procedure for the purchase – is thought to be one of the first for the public sector in England.

This new partnership will work alongside Oldham Cares Alliance partners and the Voluntary, Community, Faith and Social Enterprise (VCFSE) sector to further co-design, establish and deliver our social prescribing model. It will be led by Action Together, with Age UK, Positive Steps, Mind and Altogether Better.

We know that isolation and loneliness is on the increase with nearly 10 per cent of our residents self-identifying as lonely, so that’s why we’ve made a real commitment to tackling this through this a community-led approach.

What’s fundamentally different about commissioning through an Innovation Partnership model is that it gives our local consortium the flexibility to work and coproduce with partners and residents. Together they can design and iterate a service that meets local needs rather than a service being designed and ‘fixed’ at the outset. We know that the health and care needs of our population are changing day to day. Modern commissioning needs the agility and flexibility to respond and not be held to a rigid specification that is quickly outdated and doesn’t deliver the benefits we need. This model gives us that.

In addition, we changed the weighting of social value to 15 per cent in this procurement process, we challenged ourselves hard on each of the questions we were asking – and ensured they have a golden thread of social value running through them.

This model is also about growing our existing grassroots assets: like coffee mornings for depression and mental health, walking and running groups for physical health, street angels to address homelessness, and cooking classes for food poverty, to name just a few.

There are more than 500 community groups and activities across Oldham delivering over 1,000 activities and intervention events each month. By supporting and growing this we can help our residents to make better life choices, and this ‘more than medical’ approach to care is now positively changing people’s lives.

Our model not only focuses on linking people into community groups to meet the ‘more than medical’ need, it puts community development at its heart. If we want to intervene earlier in the care pathway to prevent health and wellbeing needs escalating, we need to provide more support for these community groups in the future.

In addition to the funding already invested from the public sector and various foundations, the Thriving Communities programme has committed an additional £1m to support groups through our Social Action Fund (to specifically tackle social isolation through five key projects) and Fast Grants for rapid-impact good community ideas, including basketball kits for the local Hoyas youth team, sewing machines for Fatima Women’s sewing project and a Nintendo Wii for an older adults care home.

Since the start of 2018 we have worked with 10 GP surgeries in Oldham West. The service has supported more than 200 people resulting in:

  • 50 per cent direct GP referrals – with the remainder being a mix of direct referral, social care, mental health, early help and other community organisations
  • 67 per cent reduction in GP attendances for the cohort who had used primary care in the past six months
  • 75 per cent reduction in A&E attendances for those who had used A&E in the past six months.

The data is from phase one and should be interpreted with care, but it shows real promise for the next three years of building the network.

This is just one example of how we are commissioning services and working very differently with our partners in Oldham in order to meet the challenges facing our residents. Our next step in 2020 is to move to a place-based model where we put people and place right the centre of what we do, and where we reconfigure our services around the 30-55k population geography. This will see us make further evolution in how we commission services and we look forward to sharing our learning with you all next time.

 

Keep it Local is brought to you in partnership with Lloyds Bank Foundation for England and Wales which specialises in funding small, locally based charities tackling complex social problems.

Principle 6
Commission services simply and collaboratively so they are “local by default”