Key to being able to leverage the power of partnerships is to have the ability to jointly influence funding, commissioning and resource.
In late 2017, the national Work and Health Programme was launched to provide employment support for people with long-term health conditions and disabilities, as well as for those who were long-term unemployed. In London, devolution of the programme has been piloted with four sub-regional partnerships each commissioning its own localised Work and Health programmes.
Haringey is a participant borough of the Central London Works (CLW) programme, as part of the regional Central London Forward (CLF) partnership. The aim for this devolved, place-based approach to a national programme, was to develop locally commissioned provision that was more aware of local need and demand, and therefore able to provide a more coherent local offer. Through devolution, while local areas have made the best of the programme, they have had to work within certain national parameters, which has impacted the way the programme has been developed.
A year into the programme, Haringey has been reflecting on a number of key challenges that are impacting the number of residents accessing this commissioned provision. These challenges include the wider complexities of the local employment support landscape, complex funding arrangements underpinning the programme (in particular European Social Fund match), and a centralised and an often-unclear referral route that requires processing through the DWP.
To respond to this, the council set up an employment and health working group, which brought together officers from partnership bodies, commissioned provision and employment providers in the borough. From the outset, it was clear that this group could potentially be refreshed to work as a powerful partnership tool to tackle the headline challenges. The understanding was that if this group could work on the immediate challenge to increase referrals into CLW, it could have a lasting impact on coordinating all work where health and employment intersect.
The approach they are taking
Haringey, supported by Shared Intelligence, convened a workshop with an expanded group of local stakeholders, building on the existing members of the employment and health working group, to consider what steps were required to strengthen all pathways towards commissioned provision. This approach would use CLW as a test case for developing a clear employment and offer and customer journey for residents facing health barriers into work.
They identified the following key steps, which will need to be taken over the next 12 months, to deliver their shared objective:
- Create a single pathway for residents to access appropriate provision in a timely manner, where residents can navigate towards the provision based on their individual needs and where benefits of commissioned services are maximised.
- Create a coherent commissioning plan which identifies need and outlines cross-agency interventions to address that need and ensure effective future commissioning and maximise impact of existing provision
- Create more robust collaborative mechanisms which allow for a sense of shared ownership and direction amongst partners in the borough and accountability
To achieve the above key steps, stakeholders recognised the need for an engine room to drive and coordinate strands of work, and to align commissioning budgets centrally. This would ensure that provision was complementary and not duplicated and was delivering against a shared understanding of need and objectives.
The aspiration for more coordinated partnership working locally is also taking place elsewhere with the Health and Wellbeing Board seeking to establish a Borough Partnership, comprised of the main providers of health and care services, residents and the Council. The partnership’s aims align well with the objectives agreed through the workshop, and in particular address the priority to have a shared view of our combined health and care resource, in order that it is used to best effect.
Through the workshop, it was noted that one of the emerging Borough Partnership’s priority themes was ‘Live Well’, which has a focus on the role that work and employment can play in improving health outcomes for those at risk of poor health outcomes, in particular people with mental ill-health, learning difficulties, autism and those with long term health conditions.
The group agreed that the above, developing Borough Partnership structure, could provide an appropriate governance framework for the work strands of the working group. This would ensure oversight, accountability and strategic focus identified as necessary to create more coherent overall pathways.
Some key learning points were identified. These included that fragmentation in the health and work agenda had caused gaps in the overall referral processes for residents into existing provision and to identify gaps in service and priority focus. Key to being able to leverage the power of partnerships is to have the ability to jointly influence funding, commissioning and resource.
With Haringey having few large employers in the borough, the council and NHS have a key dual role as commissioners and employers, needing to lead by example as employers to provide routes into their organisations for people with health conditions and other identified disadvantaged groups.