Advocacy in Suffolk: Case study
Updated: September 2020
Last reviewed: September 2022
VoiceAbility, working closely with commissioners and a range of local providers, developed a partnership model to respond to an ambitious new vision for advocacy in Suffolk. They tested the approach carefully in an initial one-year pilot. The model then moved to formal contract status, following a tender exercise.
This model of integrated advocacy is:
- delivered by Total Voice Suffolk (TVS), a partnership of five providers led by VoiceAbility
- accessed through a single point of contact
- provided as a fully integrated model, responding to evidenced need, and with flexibility to respond to variations in demand
- recorded on a single database, achieving consistency of data
- significantly improving response times, with no waiting lists for statutory services.
Suffolk County Council had a long history of grassroots advocacy provision to a wide range of people across the county. Some local services specialised in formal 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 a blend of contract arrangements and grant-aided funding. All of these providers attended the informal Suffolk Advocacy Forum (SAF) to facilitate ongoing development and training.
In 2011, the council reviewed its advocacy services and requirements with SAF and wider stakeholders, including referrers and advocacy clients. The result was a report outlining recommendations for the future. The report found that a new commissioning model was needed in order to achieve:
- strong coordination and leadership of the service
- greater equity of access for people across the county
- better consistency of support and outcomes for clients.
The Council also wanted to better highlight poor practice and abuse, and enable a wider range of people to have choice and control over services they needed.
Working closely with SAF, the local authority discussed how to achieve consistently high-quality and affordable advocacy in an increasingly constrained financial environment. They worked with people who used advocacy services, family carers, advocacy providers and local authority specialists to deliver a co-designed, integrated model of services.
Partners in commissioning, partners in delivery
In summer 2012, Suffolk County Council invited proposals from partnerships of organisations, who between them could deliver a range of specified statutory and non-statutory services, initially for a one-year pilot.
In response, the partnership ‘Total Voice Suffolk’ was formed, and took on the pilot opportunity on 1 April 2013. The partnership was led by VoiceAbility, and along with the other partners:
- Alzheimer’s Society
- Age UK Suffolk
- Suffolk Family Carers.
Following the pilot year, Total Voice Suffolk won the current contract from 1 April 2014.
The open, collaborative approach taken by commissioners and VoiceAbility (as lead provider) has enabled Total Voice Suffolk to evolve in line with the changing needs of local people and the Council.
This has resulted in many changes to provision over the life of the contract. Originally, Total Voice Suffolk delivered over 18,000 hours of advocacy provision to adults across 850 referrals, including specific non-statutory services for different user groups.
The increase in demand for statutory advocacy, particularly with respect to the Care Act, Mental Capacity Act and Deprivation of Liberty Safeguards has required a re-focusing of resource. In 2019/20, Total Voice Suffolk delivered 26,000 hours of advocacy provision across more than 2,250 referrals.
Total Voice Suffolk has also been instrumental in supporting local authority and Clinical Commissioning Group (CCG) priorities. Since 2018, multi-skilled VoiceAbility advocates have been co-located with discharge social work teams at West Suffolk and Ipswich hospitals, identifying cases where rapid access to advocacy can expedite appropriate, sustained discharge. This has reduced delayed transfers of care and readmissions.
The advocacy requests are responded to much quicker now, in fact the whole process of involving an advocate is much easier. Having one person advocating for customers in hospital means we have one person to talk to so we can simply ask for advice and information.Discharge social workers
Originally, advocacy for children and young people was not part of the Total Voice Suffolk provision. In 2019, during a review, providers highlighted that children and young people weren’t receiving the same quality of advocacy as adults. They also highlighted an increase in eligibility for young people for other statutory advocacy, including under the Care Act, the Mental Health Act and the incoming Liberty Protection Safeguards.
Children’s statutory advocacy was then varied into the Total Voice Suffolk contract from April 2020. This ‘whole life’ approach means that the service can deliver seamless support to children and young people as they transition into adulthood, especially those with the most complex needs.
Each strand of work is delivered collaboratively by different configurations of the Total Voice Suffolk providers, who work together to ensure that the right support is provided at the right time. By working together, they pool an invaluable knowledge base and relationships with key statutory and voluntary sector teams across the county.
The flexible approach means that changes in the partnership have been made in a way which ensures consistency and service improvement. This means that the partnership now includes specialist user-led mental health provision and signing advocacy for d/Deaf people. Two providers also chose to step away from advocacy provision, which was facilitated by transferring staff to other providers, ensuring no loss of consistency for people who use advocacy services.
Considerable expertise is required to hold this complex matrix together. Each partner plays a key role in making this as straightforward as possible. VoiceAbility, as the lead partner, employs a Contract Manager to ensure effective co-ordination of resource and compliance with KPIs.
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. Resources have also enabled a substantial training programme for advocates across providers.
The contract, born from the 2012 pilot, has introduced significant benefits and efficiencies:
- A single point of contact for commissioners has reduced the resource needed for contract management and enabled rapid resolution of any issues.
- A single referral point, delivered through VoiceAbility’s central hub, has reduced barriers to access and facilitated easier allocation of case work.
- A single database, used by all providers, has increased consistency of recording and improved local insights into unmet need. This has provided evidence required for innovations and additional investment as legislation has evolved.
- Improved ability to aggregate and identify low level concerns about practice and raise them accordingly with providers and commissioners.
- A larger team, comprising advocates from different organisations, has made it easier for the service to reach people across the county in a timely way, increasing efficiencies and reducing travel time.
- A common training and best practice development programme for all partners and advocates has meant information, updates and briefings are shared easily across the partnership.
- All partners contribute to sharing skills and expertise, and collaborate to develop aspects of the contract provision and mutual support.
Benefits for users and referrers
The key benefits are:
- clearer accountability – through a single Contract Manager
- ease of access – one telephone number and one website saves people trying to contact the service both time and effort
- speed of response – everyone gets a same-day response with a clear indication of how their advocacy support will be progressed
- ability to identify advocates with specialist skills – meaning that people receive consistent support from multi-skilled advocates
- more consistent approach to advocacy – an evidence-based, outcome-focused model which combines VoiceAbility’s national expertise with partners’ specialist local knowledge, delivering better results for clients
- earlier resolution – the service can work with people more quickly, more appropriately and more effectively.
A model of effective commissioning
Suffolk’s commissioning model has worked very well, and for a number of reasons:
- it was informed by research and by extensive discussion with people who used local advocacy services and with local providers
- it looked beyond a model that delivered statutory advocacy alone and recognised that non-statutory advocacy has a vital role in prevention, critical to the success of the transformation of adult social care
- commissioners and providers have worked openly and collaboratively throughout the life of the contract to meet emerging needs and respond to changes in legislation.
As a result, better advocacy is being delivered by more highly trained advocates to a greater number and diversity of people. 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.
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.Partner
And this has all meant better experiences for people in Suffolk:
Having my advocate has made all the difference.Person using the service