Issue details

The challenges facing health and social care are well documented with increasing demand due to an aging population, fragmented services and an increased cost of delivering health and social care.
At the heart of Doncaster’s way forward, the neighbourhood approach gives a focus on the individual, family, friends and communities and primary care with a shift to more prevention and early intervention rather than a reliance on statutory provision.

The Community Led Support programme has been an enabler for services to be locally focussed and delivered in a more integrated way; it has also helped to identify and provide appropriate support for people much earlier, to reduce the likelihood of them needing statutory services or presenting in a crisis. People are able to access advice, information and lower level support to stop issues escalating; professionals will have a different conversation with people that is more strength based and focussed on keeping people in their own homes and communities; and high quality responsive services will offer tailored support that is both proportionate and timely.

As this approach has developed, the provision of additional capacity to the wellbeing service to lead and drive it within communities has been critical, and has shown a real change. Imbedding of the Community Led Approach across Doncaster and our current independent evaluation from the NDTI, around our progress, has evidenced success and a significant impact of our CLS development. The evaluation was hugely positive and refers to Doncaster’s positive changes, “unrecognisable from 12 months ago” and deserving of “National” recognition for the work undertaken.

There are still huge opportunities around CLS imbedding across Communities, Health and care that are extremely pertinent and underway at present. The wellbeing officer roles are crucial, both in having those early conversations with individuals to connect them to activities and support within the local community, and also in contributing to the multi-disciplinary approach as hubs and local conversation points are developed across the Borough. To ensure adequate wellbeing resource to enable these wider system transformation streams and developments to continue, there is a requirement to extend the two existing wellbeing officers for a further 6 months up to end of March 2020.

Currently 9 wellbeing officers provide wellbeing support with 3 temporary posts funded to drive critical change in the integrated support function and provide a borough wide triage function. There is an evidenced increase in demand to the wellbeing service across various sectors, including direct wellbeing referral, Integrated Support and Assessment team (ISAT) referral to wellbeing and wellbeing triage. Ongoing promotion of early help, prevention and wellbeing support had already led to an increase in the number of cases referred to wellbeing officers, from 500 cases in 2017 to 800 in 2018, and a continuing forward trend into 2019. The new triage function alone has dealt with over an additional 140 cases away from service, so far this year. Without the extension of the 2 x wellbeing officers, this significantly affects several core, complex and critical pieces of work in the transformation of service delivery driving community resilience, increasing early identification, early help and low level prevention work, which wellbeing has been able to evidence has a significant financial and social value to the council and our communities. In 2017/19, this cost avoidance was in excess of £1.2 million on social care costs only. Without these posts we would not have the capacity to continue to meet our lower level demand on early help casework (preventing crisis and access to social care / health), continue to grow and sustain community resilience ( CLS) and underpin the ISAT transformation, which is critical to changing culture and demand to higher level services.

The posts are to be graded at local authority grade 7 and the estimated cost for 2 posts for 6 months, ranges between £22,523 to a maximum of £27,776, based on SCP points 22 – 26. Confirmation has been received from finance there is currently existing funding availability to cover these costs within the CLS budget.

There are no viable alternatives for resource to continue building this development and imbedded delivery of the CLS approach, and without this resource, our focused community and professional support to drive further enhancements would need to cease.

Following our current successes around the impact of this delivery, this would be a significant step backwards for Doncaster in the key changes we have made, both for communities and professional service provision.