Key messages and recommendations for growing innovative models of health, care and support for adults

Key messages

• Innovation is needed more than ever as our challenges grow. Innovation does not only mean technological breakthroughs or large restructures. New and better ways of delivering relationship-based care are needed, and already exist, but are inconsistently implemented or poorly scaled.
• For innovation to flourish, we need to find better ways to help people bring good ideas from the margins into core business. The keys to success are:
  • a shared ambition to ‘embed person- and community-centred ways of working across the system, using the best available tools and evidence’
  • co-production: planning with the people who have the greatest stake in our services from the beginning
  • a new model of leadership which is collaborative and convening
  • investment and commissioning approaches which transfer resources from low quality, low outcomes into approaches which work effectively
  • effective outcomes monitoring and use of data to drive change
  • a willingness to learn from experience.

Recommendations

For the Government’s vision of a sustainable, high-quality and person-centred health and care system to be realised, we need to grow what we know works. Many of the models of effective care exist already, but to a degree they are reliant on short-term, often charitable, funding, rather than core statutory funding. To get to the point where these models become part of the mainstream, there will need to be braver decisions about how local resources are spent, with money being transferred over time from low-quality, low-outcome services to impactful innovative models of care.

The Government and national partners should do the following.

• Bridge the gap between the Care Act’s vision for wellbeing and the reality of current procurement, by developing new ways to pay providers which create wellbeing and resilience
• Create an innovation scaling fund to test new approaches to scaling across local areas, incorporating the best of the approaches outlined in this paper, and fund, where necessary, the double running costs sometimes required to support promising models of care to scale. Funding must be contingent on a plan to transfer core resources into the new models, but allow time and resources to support local stakeholders to adopt, adapt and test models so that they meet local need
• Work with user-led organisations to ensure that personal budget and personal health budget holders in every area can access and make real choices with their budgets
• Support capacity building and practise exchange and coaching for social entrepreneurs and change-makers, including disabled entrepreneurs and frontline workers
• Develop an action-based learning network, with resources, coaching and facilitation support, to enable innovative local authorities and local partners to test new ideas and share learning and support with others
• Develop national measures and measuring tools for wellbeing and social connection, creating and collating datasets which can be generated by providers and used by commissioners
• Bring together the evidence base on innovative models of health, care and support, into a single ‘what works’ repository.

Local areas should do the following.

• Seize opportunities to learn from others, to adopt, adapt and scale person- and community-centred approaches, including drawing on the approaches to scaling set out in this paper (e.g. people powered results, asset-based areas and co-production)
• Establish a local innovation fund to test new ideas, with a confirmed route to long-term funding to scale. Sustain innovative community and voluntary enterprises
• Ensure that all commissioning strategies, plans and specifications are co-produced with people who use services and citizens, as well as local statutory, community and voluntary organisations
• Ensure that evidence generation is embedded within implementation, including outcome measures and evaluations to compare the social and financial impact of new and existing services and support evidence-based funding decisions
• Pay providers on the basis that they improve resilience, independence, self-care and social connections.