Total Voice Suffolk practice example of commissioning independent advocacy

Total Voice Suffolk: a countywide advocacy partnership

Published: October 2014
Updated: March 2015

VoiceAbility, working closely with a range of local providers, developed a partnership model to respond to this ambitious vision and operated it initially for a one-year pilot during which the approach could be tested carefully. The model then moved to formal contract status following a tender exercise.

This model of integrated advocacy is:

Background

Suffolk County Council has a long history of grassroots advocacy provision to a wide range of people across the county. Some services specialised in formal advocacy, including both statutory and non-statutory advocacy, delivered by paid and professionally trained advocates. Others focused on informal types of advocacy, delivered by both professional advocates and volunteers. Suffolk County Council supported this via contract arrangements and grant-aided funding.

Suffolk Advocacy Forum (SAF) brought those with an interest in advocacy together on a regular basis, to facilitate ongoing development and training during this period.  Working with the Forum and wider stakeholders including those who referred into advocacy services, and those who used those services, the council reviewed its advocacy services and requirements, resulting, in 2011, in a report outlining a number of recommendations for the future. The report recognised that in order to achieve better coordination, consistency, quality, access and measurable activity and outcome, the council needed to secure a different model that would increase equity of access for people across the county. In doing so, it wanted to enable a wider range of people to exert choice and control and have real autonomy over services they needed, but also to highlight poor practice and abuse.

While some authorities had opted to tender large unified contracts bringing together all statutory services (and any additional non-statutory services they chose to prioritise), Suffolk decided on a different approach.

Partners in commissioning, partners in delivery

Working closely with the Suffolk Advocacy Forum and its voluntary sector members, the local authority discussed changing the way services might be commissioned and delivered. A series of meetings and discussions brought together the views of people who used advocacy services, family carers, advocacy providers and local authority specialists to focus on achieving a model that would deliver consistently high quality and affordable advocacy in an increasingly constrained financial environment.

In summer 2012, Suffolk County Council invited proposals to deliver a range of specified professional advocacy services (both statutory and non-statutory) on a partnership model, initially for a one-year pilot. This coincided with the implementation of the new NHS complaints advocacy duties and the transfer of responsibility for independent mental health advocacy from primary care trusts to the local authority. Provision was also made for the development of more informal types of advocacy during this pilot year.

The pilot provision by Total Voice Suffolk, led by VoiceAbility and working in partnership with the Alzheimer’s Society, Age UK Suffolk, Impact, ACE and Suffolk Family Carers started on 1 April 2013. Following the pilot year, Total Voice Suffolk won the current contract from 1 April 2014.

The service now delivers over 18,000 hours of advocacy per annum covering a broad range of advocacy interventions and approaches (as indicated in the Figure 1). Each strand of work is delivered collaboratively by different configurations of providers and as a result is able to work responsively with a very diverse range of vulnerable adults. The service brings together into one team an invaluable knowledge base including a plethora of relationships with key statutory and voluntary sector teams across the county. Considerable expertise is required to hold this complex matrix together and each partner plays a strong role in ensuring everything is done to make this as straightforward as possible.

Figure 1: Breakdown of advocacy hours per annum and types of advocacy

Figure 1: Breakdown of advocacy hours per annum and types of advocacy

The contract does not include advocacy for children and young people with additional needs or those who are looked after.

To develop greater provision of more informal types of advocacy, a new pilot, Suffolk Community Advocacy (SCA), has replaced and will build upon the work of the Suffolk Advocacy Forum by actively supporting community organisations, enabling them to provide informal advocacy within their communities. Funding for Total Voice Suffolk also allows formal advocacy partnerships to actively support Suffolk Community Advocacy and ensure that boundaries with formal advocacy are respected for the benefit of individuals.

New investment and efficiencies

Over the past few years there has been a significant investment in advocacy provision within Suffolk, both in additional funding and in active and ongoing development support from Suffolk County Council. This investment has increased access to all types of advocacy and will enable a speedy response to new requirements, such as the Care Act 2014. Resources have also enabled a substantial training programme for advocates across providers.

The new contract, born from the 2012 pilot, has introduced significant benefits and efficiencies:

Benefits for users

The key benefits are:

A model of effective commissioning

Suffolk’s commissioning model has worked very well, and for a number of reasons:

Suffolk County Council has taken an open and collaborative approach to developing and delivering the contract, with an emphasis on ongoing development and responding to wider requirements such as the Care Act 2014. As a result, better advocacy is being delivered by more highly trained advocates to a greater number of people from more diverse groups across the county. Work and outcomes are evidenced by comprehensive data, which in turn can inform longer-term strategic planning and commissioning. Problems can be identified more easily and addressed earlier, and the collaborative spirit on which the partnership is based has enabled frank and honest relationships between organisations which have come as a bonus. As one partner explained:

The partnership has raised standards – we measure our work against each other and this has definitely raised our game. You can’t help but learn. We are more professional and there is a good mix of people. It has taken the competition out of things. No one is thinking “You might pinch my bit of work!”

And as one of the people using these services pointed out recently:

I don’t know how I would’ve coped on my own. I’m just thankful for your service.

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