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:
- delivered by Total Voice Suffolk (TVS), a partnership of five Suffolk 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
- reaching a more diverse range of people
- significantly improving response times, with no waiting lists.
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
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:
- recording, reporting and contract management is quicker, more effective and more informative
- a single point of contact has made advocacy more accessible and has facilitated easier allocation of case work
- the database for recording has benefited consistency of practice and improved intelligence about advocacy issues and awareness of unmet need; it has also contributed to the ability of advocates to support each other during times of absence
- 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, reducing the proportion of time spent travelling
- there is a common training and best practice development programme for all partners and advocates, with information, updates and briefings 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
The key benefits are:
- ease of access – one telephone number and one website saves people trying to contact the service both time and effort
- speed of response – most people get a same-day response with a clear indication of how their advocacy support will be progressed
- ability to signpost quickly to advocates with specialist skills – helpful if the individual needs someone skilled in a particular area
- ‘My story, once’ – a common database minimises the number of times people need to repeat their story
- more consistent approach to advocacy – a clearer outcome-focused, issue-based model of advocacy
- earlier resolution – the service is able to work with people more quickly, more appropriately and more effectively
- clearer accountability – it’s easier to praise the service when things go well, and to complain when they don’t.
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
- it was clear about the value of advocacy in promoting the rights of the individual
- the council was determined that advocacy should be provided by a range of providers and ensured that funding was available to manage and support a partnership model.
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.
All SCIE resources are free to download, however to access some of the following downloads you will need a free MySCIE account:
- Care Act 2014: Commissioning independent advocacy
- Commissioning independent advocacy guide
- At a glance summary of Care Act 2014: Commissioning independent advocacy
- Easy read summary of Care Act 2014: Commissioning independent advocacy