A positive future for wellbeing in York – turning the tanker of health and social care

Featured article - 20 July 2018
Corporate Director of Health, Housing and Adult Social Care, City of York Council

Head-shot of the author, Corporate Director of Health, Housing and Adult Social Care, City of York Council

The nature of the historic city of York is one of a city that looks to the future. The bridges, the city walls and the many industries that took root here, from chocolatiers to railway engineers, even the Vikings and Romans, are testament to a city that understands its strengths and uses them to meet challenges.

About a year ago I wrote a blog piece about York’s journey to becoming an asset-based place. I spoke of our ambitions to harness the strengths, skills and networks that run deeply in this city to support people to lead healthy, independent and fulfilling lives.

This model is about community asset led services, and it is grounded in co-production and personalisation principles that seek to promote self care / management and, most importantly, link people to ‘place’. It is a model that will support individuals in their communities with a key emphasis on prevention, early intervention and good quality advice and information to support people to make informed decisions.

Begining to bear fruit

Almost a whole year has passed since I wrote those words and while many things have not changed - the pressures, financial and demographic, are still very much present - our work to transform ourselves is beginning to gather pace and bear fruit.

In March of this year we began operating our very first community hub. Instead of placing people onto a waiting list for a full social care assessment, for these people:

  • Waiting times have been slashed. From an average of 9-12 weeks wait for an assessment, the average time between 1st contact and being seen in a hub is now less than a week
  • 100% of people invited to the hub have said they were satisfied with the experience and, most importantly their outcomes from attending a Talking Point
  • Less than half of the people who would have otherwise gone onto a full social care assessment chose to have one, and instead was supported by alternative existing community options
  • The number of people going on to require paid for social care services has fallen by over a third from an expected level of 65%, to only 43%.

It is, admittedly, very early days, and as we are just opening our second community, in partnership with Age UK, we will continue to monitor the outcomes for people. From what we have seen so far, we are delivering better outcomes, reducing dependency, increasing resilience and taking pressure off statutory services.

Positive feedback

We continue to work with our partners and colleagues in health and in the community and voluntary services to support us, and in turn offer our support to them as we build this new way of working. So far the feedback has been extremely positive, from key partners in health and the community sector, equally importantly our own staff.

York is still very much at the start of its journey towards becoming an asset based place, but this city has undergone many changes, reinventing itself successfully in the face of many challenges. This is one more change, and one we see the community embracing and shaping and, as it has done countless time before, using its resources and assets to safeguard the present and build a better future.

To summarise the journey to date

  • Initial discovery phase to develop the model
  • 2nd phase focused on implementation, development and delivering a shift in culture

Moving from a traditional reactive approach focused on costly statutory provision to

  • Design based on co-production / personalisation principles
  • Investment in early intervention / prevention linked to PLACE
  • Managing demand proactively
  • Focus on delivering better outcomes
  • Reduced dependency / Increased resilience / reduced delays
  • Reducing pressures on key services – longer term sustainability
  • Efficient use of resources. Delivering savings
  • Liked by customers and staff alike

I was once accused by a close friend and colleague of being an evangelist. I’m proud to say it’s true as I passionately believe in the journey we are on. The secret is there is no silver bullet, it’s a philosophy, bringing together a range of complimentary initiatives, bottom up and top down, co-production in action – a different approach.

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