Joint Working:the good, the bad and the ugly

Lisa DoddChildren’s Lead

for Commissioning

NHS SOTW

Debra Patterson

Service Manager for Disabled

Children

Gateshead Council

Jessica Moore

Aiming High for Disabled Children

Manager

Gateshead Council

3rd June 2009

Demographics

• 190,500 residents

• 44,200 children aged 0-19

• Approx 470 severely disabled children

• Less than 5% from BME communities

• Large orthodox Jewish community

3rd June 2009

Joint working in Gateshead:

• Children’s Services rated “outstanding” across all areas in latest APA

• Children’s Trust Pathfinder – 2003• Examples of recent joint working through

pilots and pathfinders:– Budget Holding Lead Professional – Short Breaks Pathfinder & IB pilot– Targeted Mental Health in Schools– Family Pathfinder

3rd June 2009

Key principles for partnership working in Gateshead

3rd June 2009

Clear, shared objectives

• Our vision for children and young people in Gateshead is for them to be:

“empowered and supported to develop to their full potential and have the life-skills and opportunities to play an active part in society”

3rd June 2009

Clear framework of responsibilities and accountability:

3rd June 2009

High levels of trust:

• Well-established relationships

• Open and honest dialogue

• Remember it’s not personal!

3rd June 2009

What are the key challenges and barriers to effective joint working?

Question:

3rd June 2009

Key Challenges in Gateshead

• Resources – the £ discussions are often the worst!

• Dominant characters• Differences:

– Infrastructures– Language– Processes– Working arrangements– Organisational cultures

3rd June 2009

Key Challenges in Gateshead

• Re-organisation of the PCT– The Provider / Commissioner split

• Getting partners to agree on priorities and stick to the priorities

• Information sharing across agencies

• Keeping partners engaged and involved

• Preventing “talking shops” from developing

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Overcoming the challenges

What do you think are potential solutions?

3rd June 2009

Overcoming the challenges in Gateshead

• Integration - health lead seen as a key member of the LA team with the development of joint posts

• Sharing the workload – lead responsibility

• Clear communication about responsibility

• Joint review of services – with engagement and involvement at all levels

3rd June 2009

Overcoming the challenges in Gateshead

• The use of benchmarking to learn lessons from partnerships elsewhere

• Looking for opportunities rather than barriers “we can” rather than “we can’t”

• Spending time together to understand each other’s values and thinking

• Understanding that disagreements are part of a healthy relationship

• Joint strategies – commissioning for example

3rd June 2009

Critical success factors

• Information sharing protocols

• Clear outcomes:– time-lines– resource allocation– review processes and responsibilities

• Performance monitoring

3rd June 2009

… The “So What?” Factor

• Multi-agency early support pathway means that families receive joined-up services

• Joint assessments for holistic packages of care means fewer children in Out of Authority placements

• Health sign-up to Network of Children with Disabilities means we know who more of our families are

3rd June 2009

… The “So What?” Factor

• Joint Commissioning Support Team

• Pooling funding enables us to commission more

• Multi-agency service reviews enable us to identify gaps and reduce duplication

• Evidence of good joint working levers in additional grant funding – Short Breaks Pathfinder, IB pilot, TSP offer 1

3rd June 2009

Coming together is a beginning.Keeping together is progress.Working together is success.

Henry Ford

3rd June 2009

…over to you.

www.dcsf.gov.uk/ecm/ahdc