Integrated Children’s Services - First Steps - Rod Matthews 27 July 2005

Integrated Children’s Services

- First Steps -

Rod Matthews27 July 2005

Page 2

First Steps – a Framework for Integrated Children’s Services

Agenda 13:00 – 16:30

13:00 Introduction RM 13:10 National Projects in context RM 13:15 First Steps – a combined perspective RM 13:45 Key Issues from the Social Exclusion Unit RT 14:15 Break-out session

15:00 Break

15:20 Key Issues from the ISA Programme MS 15:40 Key Issues from the IDeA RM 15:50 Break-out session feedback RM 16:00 Question time & next stepsPanel

16:30 Close

Page 3

National and Regional Projects in Context

2002-2005

22 National Projects& £80m spent, 9 Regional Partnerships, c40 Sub regions, plus the thematic Partnerships with a wide range of ODPM and locally funded programmes.

The outcomes is a wealth of products, a small number of which are software (16), a bout 200 are about methodology and around 850 are knowledge products. These are available via ‘PROP’ & the NWeGG products catalogue, and there is a drive to combine product databases

There is an issue that the products tend to be individual and need to be accessible to practitioners and those that can affect change, they need to be seen in context.

The future of National Projects – Local Authority led following the ROADS “Safe homes” programme.

Page 4

First Steps – a Framework for Integrated Children’s Services

A combined perspective

• National Projects, Regional & sub-regional Partnerships, thematic• Identification Referral and Tracking • Information Sharing And Assessment Programme• RYOGENS• FAME• Common Assessment Framework• Children Act 2004• Integrated Children's Service• Single Assessment Process• Single Assessment Record• Single Child Index• Electronic Social Care Record• Personalised Learning Environment• NHS National Programme for IT• Government Connects (Gateway)• Priority Service Outcomes

Page 5

Knowsley’s approach to the ROADS Programme

• We recognised that the ‘interested parties’ were finding e-government and National Projects too nebulous and too techy in their language.

• We also were confused by overlaps and competing initiatives, We too had problems in translating the individual and sometime competing products into a meaningful business case, relevant to Knowsley’s circumstances.

• We were particularly concerned at the lack of cross-agency understanding, and specifically the funding / cost of such programmes.

• I was concerned that Children’s Agenda was in the “too-hard box”, and that against the size of the task, that developments were slow to initialise

• But at the same time we were hearing about lots of really good work happening – perhaps too much!, and some anxieties reached as far as Hansard!.

So I volunteered to try and bring together, rationalise the respective strands, products and discussion on Children’s Services, to write them up and make the findings available with some of the how-to products included

Page 6

First Steps – Introducing Gaps, overlaps, thoughts and hints

First Steps - Structure of the document;

Section 1 - Policies Stakeholders and Initiatives

Section 2 - Agencies, teams and business processes involved

Section 3 - Cost, Affordability, redistribution – impact and effect

Section 4 - Structured methods, governance, change and communication

Section 5 – Technologies and information management

Page 7

The real aim

2

1

3

4

Page 8

First Steps Section 1 – Central Government Scope

Department forEducation and

Skills

Office of DeputyPrime Minister

Home OfficeDepartment of

Health

LOCAL AUTHORITY AND PARTNERSR

ed

ucin

g C

rim

e

Page 9

First Steps Section 1 – Local Authority Scope

Crime and Disorder

Health & Social Care

Education

Single Child Index RYOGENS

Regional SchoolsAdmissions Portal

ISAP

Next Agenda Item – 13:45 (Social Exclusion Unit)

Page 10

First Steps Section 2 – Stakeholders and Processes

ROADS National Project

Practitioners

Sponsors

Client groups

Children

Young People

CYPSP

ODPM

Leisure & Community

Parents

Carers

DFESDOH

eGov Leads

IT managers

Directors of Children’s Services

ISA Programme Managers

ICS Programme Managers

Acute Trusts

Primary Care Trusts

Connexions

Housing Services

Social Services

Education Services

Schools

CAMHS

Youth Offending Teams

Youth Inclusions Support Panels

Police

Probation

Non-practitioners

Voluntary Sector

External

Technology Partners

Page 11

First Steps Section 2 – Stakeholders and Processes

Self Referral

Process Start

1 Part of the eligibility assessment should include a initial provision of service received by other agencies.2 Consent from either or both the child and parent / carer.3 Request support using individual agency referral forms to contact appropriate agency

Contact leadpractitioner and

share information innext meeting

Close Referral / Request forsupport

Are child’s needsbeing met?

Call a Multi-AgencySupport Meeting

Review supportplan / CAF

Actions and Decisions Process End

Deliver Service andplan ongoing review

meetings

Contact practitionerby phone. Co-

ordinate intervention.Share information

verbally

Has consent beengranted?

Request for support from ownagency / other agency

Assess eligibility ofeligibility for

services from thisagency1

Will this referral beaccepted?

Should a referral bemade to another

agency?3No

Close Referral / Request forsupport

No

Seek Appropriate2

Consent for serviceintervention.

Refer to Level 3 Services (seelevel 3 flowchart)

!!! IF at any stage in the process the child is at risk of significant harm, child should be referred to Social Services immediately !!!

KEY

Process start

Process step

Decision

Process end

Child Index

Area ofresponsibility

Refer to alternative Level 2Service.

Is refusal to grantconsent a child

welfare concern?

Yes

How many otherpractitioners are

working with child?

Yes

2 13 or more

Identify leadpractitioner.

Develop MultiAgency CAF

Select Date forreview meeting

Multi-Agency Planning Meeting

Planning

ServiceProvision

Continue existingsupport?

Are additionalservices required?

No

Yes (level 2)

Close Referral. Return toLevel 1 Provision.

No

Yes

No

Review

Yes No

No

Yes

none

Yes (level 3)

Multi-Agency Review Meeting

Agency checks ifchild known and if

assessments / CAFalready exist

Create/UpdateCAF

Record involvementin Child Index

Referral triggered bycharacteristic,

e.g. poor school attendance

Page 12

First Steps Section 3 Identifying Affordability

4

3

2

1

Immediate< 1 year

Short Term1-2 years

Medium Term2-5 years

Long Term> 5 years

Costs (£) Over 6 Years

Low Estimate High Estimate

People (240,000) (240,000)

Technology (675,000) (840,000)

Project/Programme management

(100,000) (200,000)

Total (1,015,000) (1,280,000)

*See section 3.2 for a more detailed explanation of financial costs.

Benefits (£) Over 6 Years

Low Estimate High Estimate

Efficiency 500,000 3,500,000

Preventative 600,000 3,000,000

Total 1,100,000 6,500,000

Long Term Economic Benefits

The long term economic benefits have been estimated in section

2.1.3, but are not included in this table. They relate to a 45 year period and are not comparable

with the other figures in this table.

Page 13

First Steps Section 4 Change Management

• Readiness Assessment Checklist

• Model Project Approach

• Model Communication Plan

• Model Change Plan

• Template Risk Analysis

Cen

tra

l

Man

ag

em

en

t

Ch

an

ge

an

d

Co

mm

un

ica

tio

ns

Bu

sin

ess

Desig

nT

ech

no

log

yVision and Strategy Initialisation Design and Build Deploy and Implement

Vision and Scope Statements

Stakeholder Analysis Change Planning

As-Is Analysis

To-Be Design

Technology As-Is

Practitioner buy-in

Team structure and mobilisation

Internal and external communications

Adapt information sharing protocols

User Training

Info

rmati

on

Man

ag

em

en

t

Leadership Champions

Post Implementation

Monitor and Evaluate

Training Strategy

Local Training plans

Evaluation Report Process and information maps

Information Requirements

Change Plan

Implementation Plan and To-Be Design

Job Descriptions

Information Sharing Protocols

Local Communications Plans

National Communications Plan


Stakeholder Analysis

Training Strategy

Local Training plans

Evaluation Report Process and information maps

Information Requirements

Change Plan

Implementation Plan and To-Be Design

Job Descriptions

Information Sharing Protocols

Local Communications Plans

National Communications Plan


Stakeholder Analysis

Technology To Be ICT Implementation

ICT Test

Benefits Realisation

Page 14

First Steps Section 5 Technology and Information

Education Health Social Care

Crime & Disorder

Single Child Index

• CRM or not to CRM

• Wait ?

• Develop interfaces model in LGOL-Net

• Data matching

• Access control

• IOUM / IONM


Page 15

First Steps Section 5 – Information sharing protocols

Knowsley

Information Sharing & Assessment

The IS Toolkit Model

Tier 1:IS Framework

(Strategic Level)

Tier 2:IS Arrangement

Operational Instruction(Practitioner Level)

Tier 4:

(Operational Level)

PrivacyConfidentiality & Consent

(Service User Level)

Raising Educational Achievement for All

Tier 3:

IS Checklist&

Self-Assessment


ODPM Social Exclusion Unit

Richard Turl

27 July 2005

Breakout Session 14:15 – 15:00

Group 1 - Policies Stakeholders, Initiatives and Agencies

Group 2 - Cost, Affordability, Performance and Change Management

Group 3 - Technologies and information management

Group 1 - Policies Stakeholders and Agencies • Who appears to be engaged / or not

• What are the key dates – events

• What is agency / practitioner restricted and unrestricted data

• What are the key issues with the role of the lead practitioner

• Is notification (IONM) as far as we will ever get based on current organisations

Breakout Session 14:15 – 15:00Group 1 Facilitator TBA

Page 19

First Steps: Break-out Feedback – Group 1

Group 1 - Policies Stakeholders, Initiatives and Agencies

Most of the discussion centred on the role of the Lead Practitioner, as the leading edge of the stakeholder groups concerned.

Some organisations use the term Lead Practitioner and Some Lead Professional, and it was felt useful to standardise.

Should the lead practitioner be defined by the stakeholders, or by the family / child as their chosen, most trusted or most available contact. Given the potential range of contact/scenarios for the lead, they need to be CRB checked, this would have to include third sector (voluntary organisations).

Group 2 - Cost, Affordability, Performance & Change Management

• Who is paying for the integration

• Should there be a redistribution of costs

• What is the term – is short term 1 year or 5 years

• What is the balance of performance indicators from BV to QoL

• Is there a single ICS programme in your Authority

• What Communication is taking place

Breakout Session 14:15 – 15:00Group 2 Facilitator Rod Matthews

Page 21

First Steps: Break-out Feedback – Group 2 (1 of 2)


There are potentially different approaches to defining the scope of Children’s Services, and how to address the CSD Portfolio, with moveable Boundaries between Adult and Children’s services. So far there may have been an apportioning existing resources and some pressure on accommodation budgets, but this seems to be shuffling the resources and there seems to be much less clarity over capital for systems and change.

There was a feeling that there was an emerging link to the efficiency agenda, but that due to the reapportionment of people, their net capacity being focused on children’s services, perhaps meant that (without additional resources) that their efforts towards the efficiency agenda might be of a lower priority.

It was felt that the source of new capital was unclear and that it might be attached to bidding, with potentially annual cycles if missed. But it was also strongly felt that whilst there is an IT element that the programme is very much more about the softer issues in transformation change, partnership and culture development.

When considering that the programme may cause a net efficiency, there were some question as to whether all of these can all be claimed from the implementation of integrated services, or whether some of these were about changed business practice (ie implementing EDM) that may have occurred separately, or as part of this programme. Some questions over what might be expressed in the Annual Efficiency Statement.

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In terms of savings, it was recognised that the LA was bearing the brunt of the costs and therefore the % of savings was small in comparison to the spend on services (sub 1%). It was questioned as to whether the saving should be passed back up the line from NHS / Police and over what period the changes should be monitored / analysed.

It was further questioned as to what period of time the results were expected in – would politicians commit to a cause and effect that was greater than 4 years

There were some concerns over KPI(s) and a fairly universal view that the organisations were very much defined by the impact in PIs, but also some great ideas about impact assessment, reduced waiting lists. It was also recognised that savings and PIs may be affected by latent demand.

Finally it was considered essential to get the attention of the Chief Execs and Finance Directors to lead this agenda as their appeared to be Weak Strategic (from the centre) Leadership which was leaving too many unknowns

Group 3 – Technologies and Information Management

• CRM or not to CRM

• Data Matching

• Will the culture accept automated referrals based on flags of concern

• Is the NHS Code of Connection a necessity -

Breakout Session 14:15 – 15:00Group 3 Facilitator Joe Daniels

Page 24


Group 3 - Technologies and information management A popular group, but recognising that this is a business led issue and that technologies need to create the capacity;

Must have cross silo input and direction

Requirement Base Infrastructure

InformationManagement

DataSharing

FormFollowsFunction

More than ‘just’ IT

IT pushing forwards, but who should be leading ?

Especially with regard to data leadership

But, we don’t know what tools there are - yet

Page 25



CRM

Council could hold an index, but CRM but not necessarily as a core ICS delivery System

There are many other systems

Data matching is really the issue, esp for the children most at risk

Lot of local (people) knowledge used now,.

A resource not to be ignored

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Joined up working

Working, multi-agency, mixing cultures

Needs top down – driving from Central Gov

National Agreement to govern index being mooted

Local eGov Standards Body – moving Slowly

DfES

Becomes v hard with the large no of agencies

People happy to share data if the benefits are clear (SEU) Point

Who’s data is it ?

Info Sharing Toolkit exists, but no standard

Page 27



Single Child Index

Need to address suspicions over why data is being held and what the benefit is

Should there be an opt-out?

Raises question over who chooses to

Legal , National Act?

More likely to be local than national

But more about info sharing

Page 28



NHSCode of

Connection

Use ?

Very hard to meet requirements, and is expensive

Its going to get harder and more complex as more people become involved in delivering children’s service

Tracing service

Access to local patient record ?

Difficult to balance with access to social care record Use ?

Page 29



Suppliers

Anite

Building Offering

Capita EMS

£120k for Children’s System Middleware

Do you split adult and children’s systems

Need to get away from paper based filing

If it is one system then this helps the family view

But if one, this needs to manage any internal conflicts between CSD / Education and Social Services

BREAK

15:00 – 15:2027 July 2005

DfeS Information Sharing and Assessment Programme

Mark Simmonds

27 July 2005

Improvement and Development Agency

27 July 2005

Page 33

I&DeA and Integrated Children’s Services

Related activities in the North West

• Extended Schools http://www.idea-knowledge.gov.uk/idk/core/page.do?pageId=1721743

• Role of District Councils http://www.idea-knowledge.gov.uk/idk/core/page.do?pageId=1715891

• Stocktake http://www.idea-knowledge.gov.uk/idk/core/page.do?pageId=611896

Contacts http://www.idea-knowledge.gov.uk/idk/core/page.do?pageId=877209

Events

NWest events are being held in Nov and March http://www.idea.gov.uk/children

Page 34

First Steps – Question time and ‘next steps’

• National Projects in context & is Aligned with IDeA / DfES / ODPM

• Considers the objectives, converges and creates a logical sequence

• Takes product from across NPs and applies them in a defined objective

• Tells a story for Practitioners, Chief Executives & Finance Directors

• Discusses the policies and targets

• Builds upon the ROI methodology, Sprint4, and Prince2

• Commences a cross-agency business case discussion

• Aims to help get people mobilised

• Full document is available at;

http://development.knowsley.gov.uk/downloads/firststeps.html

Integrated Children’s Services

- Close -

Rod Matthews27 July 2005

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Integrated Children’s Services - First Steps - Rod Matthews 27 July 2005