iESE recognises health and social care trailblazers

This March saw the 15th anniversary of the iESE Public Sector Transformation Awards with Bronze, Silver and Gold winners across eight categories celebrated alongside individual winners for UK Fire & Rescue Service of the Year, UK Police Service of the Year and International Public Body of the Year and the overall iESE Council of the Year 2024.

More than 200 submissions were received from 70 public sector organisations. Here, we focus on the three finalists in the Transformation in Health and Social Care category.

GOLD: Together for Children –Transformation Management Office (TMO)

In just three years, Sunderland Children’s Services (SCS) and Together for Children (TfC), which deliver children’s services on behalf of Sunderland City Council (SCC), became the first ever local authority children’s service to jump from an inadequate Ofsted rating (2018) straight to an outstanding judgement (2021).

This incredible transformation was, and continues to be, strongly supported by a new department within the organisation known as the Transformation Management Office (TMO). This team, which was developed alongside and funded through the Department for Education (DfE), works in collaboration with colleagues in Early Help, Social Care and across the organisation. The team includes a strategic programme manager, one programme lead, three project managers, two project coordinators and one graduate project and change support officer, all supporting the organisation to deliver an evolving transformation programme. Its work covers four important areas: Digital, Data and Intelligence, Working Efficiently, Capacity Building (for young people) and Income Generation. The TMO has so far supported a wide portfolio of more than 40 projects which directly benefited children and families in Sunderland.

An example of a project the TMO has been fundamental to is Breathing Space, an innovative whole family initiative that provides space, time, and support for young people with additional needs and their families and carers. The project, which is now in its second year and has been cited in national guidance as good practice, has received £700,000 of funds to progress several exciting developments. This includes opening a fourth short break hub in partnership with the Autism Outreach Team to run after school hubs and Early Help working directly with primary and secondary schools. The number of referrals and attendance at hubs continues to rise steadily and there has been an incredible number of positive outcomes, including 80 per cent of children/young people maintaining or improving their emotional wellbeing, young people having the chance to make friends, reducing suspension and exclusions from school, and parent and carers feeling more supported.

The TMO also fully supported the initial development of the Wear Together Edge of Care outreach team. This project has seen incredible outcomes where family situations have been stabilised through a whole family approach. The TMO has supported multi-agency relationship building, culminating in several multi-agency posts coming into the Edge of Care team, including a Speech and Language Therapist and a Police Officer. One of the project’s non-financial aims was the prevention of children and young people becoming cared for, thus improving their outcomes and opportunities to thrive at home. More than 90 per cent of children involved with the Wear Together team remain out of care in the 12 months post involvement.

The TMO has also assisted with the leasing, set up, expansion, amendment, purchasing, and registration needs of several children’s homes and independent living accommodation properties. The team has also helped establish the Fostering Mockingbird project where one foster home becomes a hub for a further 6-10 foster care families.

As a result of the initiatives, total cared for children’s numbers have fallen from a high of 632 in February 2021 to a current 522. The projects undertaken have also helped in the reduction of children homed in costly external accommodation from a high of 52 in February 2021 to 38 in November 2023, having both a dramatic effect upon the outcomes of children and spending.

The TMO team constantly place children and young people at the heart of what they do, adding considerable value to TfC’s improvement journey.

The team are firmly on the map in the North East for providing professional and quality programme and project management, resulting in recognition locally and nationally for its work.

Kevin Brown, Strategic Programme Manager at Together for Children Sunderland, said: “Myself and the transformation team at Together for Children were thrilled to receive the award from iESE and recognition for the part played in the incredible transformation journey that Together for Children has been on. It goes without saying that the transformation achieved would not have been possible without countless colleagues throughout the organisation and their unwavering commitment to delivering outcomes for the children and young people of Sunderland.”

SILVER: South Ayrshire Health and Social Care Partnership –Transforming Children Services

In 2019, driven by a vision statement of “keeping South Ayrshire’s Children in families or family type care”, South Ayrshire Health and Social Care Partnership (HSCP) invested in a new Children Services leadership team to help enable a whole system transformation and culture change.

A Care Inspectorate report in 2016 highlighted that South Ayrshire had a disproportionate number of children in costly external care placements, a lack of early intervention services and too many children being referred to the Scottish Children’s Reporters Administration. Additionally, there were higher than average numbers of children on the Child Protection Register and the HSCP children services budget was badly overspent.

An investment of £465,000 was approved by the South Ayrshire Council Leadership Panel in early 2020 to support transformation. This included the introduction of the Belmont Family First Model, implemented to assist children and families at a school called Belmont Academy and its cluster primary schools. This project works in partnership with schools, health, and community partners to support families to identify strengths, assets and resources that may enhance their wellbeing and enable them to reach their own goals. The project aims to provide valued and timely support to children and their families at the earliest opportunity, empowering families to strengthen their relationships, grow together, develop resilience, and reach their full potential.

For the Family First approach to be successful, it was also imperative to address the culture of the organisation, including improving recruitment, retention, and sickness absence. It was decided that in parallel to the Family First approach, HSCP would implement Signs of Safety, a strengthsbased model to provide a framework, common language and value base which services would work collaboratively within. This required a whole system commitment from key leaders within the Council and HSCP, from Chief Executive and Elected members to frontline operational staff.

With the Signs of Safety approach, families work alongside professionals, discussing worries and concerns, identifying the things that are going well (strengths) and agreeing what needs to be done (goals). This approach allows the family to build on existing strengths and reduce their worries, with the views of children, young people, their parents, and carers central to this work.

The Family First model was developed further with South Ayrshire Education colleagues and together has transformed the way that South Ayrshire cares for and supports children and families. Through the effective use of early intervention and keeping families together in their local schools and communities, South Ayrshire can evidence a 56 per cent reduction in the number of children removed from families and placed in expensive Out with Authority (OWA) residential placements. The Belmont Family First team have diverted 28 families (37 Young Persons) away from escalation through the care system. These are young people who could have been expected to progress into external OWA residential care.

The Family First approach and Signs of Safety model has also resulted in a 79 per cent reduction in the number of children deemed to be at Risk of Significant Harm and registered on the Child Protection Register (CPR). There has also been a change in the overall balance of care, with a 53 per cent reduction in the number of children referred to the Scottish Children’s Reporters Administration in need of care and protection from 2016, as well as a 67 per cent reduction in the number of children subject to Compulsory Supervision Requirements from 2016/17 to 2022/23.

A base line audit taken in 2021 and a retest in September 2023 demonstrated a positive shift in feedback from parents and carers. For example, 64 per cent of respondents said their social worker had been clear with them about how they see the concerns within the family, compared with 27 per cent in 2021. In relation to families feeling that social workers care whether their family resolves their problems, this improved from 35 per cent in 2021 to 69 per cent in 2023.

Internal staff surveys have also found a significant decrease in differing views between staff and leadership. This is important in creating a positive climate and culture within South Ayrshire. The alignment of values between the leadership and frontline operational staff is more likely to contribute to a successful implementation and improved outcomes for children and families.

Mark Inglis, Head of Children's Health, Care and Justice Services, said: “We were delighted to receive this award at the iESE Public Sector Transformation Awards. This is a strong affirmation of the journey that we have been on in South Ayrshire. This was only possible through the hard work of the front line HSCP teams, specifically Social Work and the strong partnerships they have developed to improve experiences for our young people in South Ayrshire.”

“This award shines a light on the extremely positive and collaborative relationship that we have with Education and shows that when services get out of their silos and work together, we can achieve better outcomes for our children and their families, for less of the budget,” he added.

BRONZE: Rochdale Borough Council – Raising Rochdale SEND Alliance

In 2021, Rochdale SEND Alliance initiated the Raising Rochdale – Supporting SEND children, young people, and families project with the aim to “make the borough a great place for all to grow up, get on and live well”. A key driver of the project was breaking down silos to ensure services for disabled children are integrated from design to evaluation.

Together, Rochdale Borough Council and the Heywood, Middleton & Rochdale Integrated Care Board and partners, including those with lived experience, created a multi-agency SEND Alliance, which includes those with lived experience and professionals, to improve support and outcomes for the 7,000-plus children and families requiring special educational needs and disabilities (SEND) support.

The Alliance mapped services to recognise gaps and patterns, developing a strong information sharing system, including creating a multi-agency, cross-system dashboard, and seven SEND outcomes co-produced with children and families. As a result, Rochdale has gone from having no framework for children and young people with SEND to becoming a nationally recognised, exemplary model for achieving strategic change.

Developing a framework using an outcomesbased approach was a vital foundation for this project, to give different SEND services overarching goals and a common set of measurable objectives. To do this, partners were brought together to identify how they could pivot from being outputfocused (prioritising what is delivered, irrespective of impact) to being outcomes-focused (prioritising the difference made to children’s lives).

This included the development of strategic outcomes with a multi-agency group, including children, young people, and their families. Alongside these, a list of measurable metrics to monitor progress towards the outcomes were produced. In addition, the framework also included a vision, two spotlight priorities (children being close to home and children staying in education) and actions with improvement plans.

Other steps taken included:

Joint Strategic Needs Assessment (JSNA) – To build this, Rochdale’s senior leadership team worked closely with all agencies and the National Charity, The Council for Disabled Children, to compile data and develop a SEND-specific JSNA, enabling a shared understanding of the population, their vulnerabilities, and needs. The JSNA is used extensively for commissioning purposes and underpins all other work taking place across the system.

Mapping Early Interventions – Mapping existing early intervention allowed greater understanding of areas of strength and highlighted areas for improvement. The mapping allows responsive commissioning and has increased access to early intervention and improved the lived experience of those accessing this provision. An additional £5m has been invested into early intervention for children in the last two years, resulting in reduced waiting times for some specialist pathways.

Developing an Ordinarily Available Provision Framework – Meeting needs early is central to meeting them effectively. Schools and settings are key to this, and recent co-development of an Ordinarily Available Provision Framework has enabled stronger partnership working. All Primary Schools have now adopted this model, with secondary schools joining this journey more recently. Improving data and information sharing – A Data Think Tank involving multiagency senior leaders runs regularly to collaboratively develop a SEND multiagency data dashboard and improve effective information collection mechanisms.

Developing strong progress and accountability measures – An audit tool was developed to support joint working between agencies to evidence the effectiveness of local SEND processes.

The initiative has already reduced waiting times for autism, Occupational Therapy, Physiotherapy and Emotional Mental Health Support. Families requiring support for Neurodiversity are reporting increased satisfaction and shorter waiting times due to the introduction of an Integrated Neurodiversity Hub. There has been a significant reduction in Mental Health crisis escalation, while parents report confidence in the leadership and children and young people report individual progress against their outcomes.

With the SEND system under scrutiny nationally and locally, Rochdale is working to ensure a stronger and more person-centred approach to SEND commissioning. This will support developments across Greater Manchester Integrated Care System and national direction.

“We are proud of the fact that support in Rochdale is gaining national recognition and for the support of the iESE Transformation Awards for recognising the efforts that our families and stakeholders have made. We are on a journey and still have lots to do but we are proud of how far we have come over the last four years and that it is beginning to make a difference for some of our families,” said Charlotte Mitchell, Assistant Director of Integration and Health, Rochdale Local Authority and Heywood Middleton and Rochdale, Integrated Care System.

Read more about the iESE Awards winners in the special edition of Transform Magazine: https://issuu.com/ksagency.co.uk/docs/transfor m-39_iese_winners_2024

For more information about the iESE Awards, please visit: https://iese.org.uk/public-sectortransformation-awards/