Good practice – Turning Point

Working with communities to design and deliver health care solutions

Summary

Turning Point’s Connected Care model works across the commissioning cycle and is based on training up local people as Community Researchers who go on to engage with communities (general or specific) to look at future service needs. It enables commissioners to involve the community in designing and delivering new solutions. This case study describes the model and gives detail about how it has been used in South Worcestershire and Warwickshire.

Overview of public involvement activity

Connected Care is Turning Point’s award winning model of service development.

It is based on training up local people as Community Researchers who work with communities to look at future service needs. It enables commissioners to involve the community in designing and delivering new solutions. Establishing sustainable and peer led ways of working with communities contributes to service design and improvement, better outcomes, improved community resilience and social action.

Local people, often service users who have complex lives, are recruited and trained as researchers, champions and advocates. Once trained they engage other local people, with an emphasis on people whose voices are seldom heard. Researchers use a range of tools including online and face to face methods, to find out what is working, and what isn’t, and identify ideas from the community about solutions to local issues and how people can be supported to stay healthy and independent.

So far the Connected Care team has worked in 19 areas, recruited and trained over 250 community researchers and given 11,000 people a voice in the design and delivery of their local services.

South Worcestershire Clinical Commissioning Group (CCG) and Worcestershire County Council used the Connected Care methodology to engage the community in three of the most deprived areas in Worcester city with the aim of helping people with chronic health problems to better self-manage.

A team of local residents, trained by Turning Point, used their own links within the community to reach people not currently engaged with services. They were able to present a picture of the demands on people’s lives and health locally that formed the basis of three community-led pilot projects: a community wellbeing campaign including 200 peer to peer ‘wellbeing conversations’, a ‘time to talk’ drop-in delivered by Community Champions at the GP surgery providing peer support and sign posting and a five week lifestyle course and peer support group for people living with a long term condition.

Evaluation of the pilots found:  improved wellbeing and reduced social isolation; increased uptake of local services including health trainers and health checks; and improvements in healthier eating, moderate exercise and reduction in smoking. The project was a finalist in the 2014 NHS England Excellence in Participation Awards and the CCG has rolled out the ‘time to talk’ drop-in across five GP surgeries.

Who carried out the activity? 

Connected Care is facilitated by Turning Point, which recruited and provided training for 17 local people who became Community researchers. Training covered presentation and research skills and techniques. Other people involved in the project included the Commissioning and Steering group members representing the CCG, County Council, City Council and Community Trust.

What difference has the activity made?

Outcomes from previous Connected Care projects found that it contributed to:

  • new community networks
  • better knowledge and uptake of services in the community
  • integrated service provision across health, care and housing
  • people taking more responsibility for managing their own health and wellbeing
  • reduced need for crisis intervention and hospital admissions; and new forms of social action

Research conducted by the London School of Economics (LSE)[1] in this area concluded that investment in community initiatives were both cost effective and generated net economic benefits over both short and longer term due to reduced need for social care services. LSE analysis found that: Time banking saved £1300 per member based on a cost of £450; Befriending saved £35 in the first year rising to £300 in subsequent years for a cost of £80; and Navigation saved £900 per person for a cost of £300.

As less is being spent across almost all public sector services, increasingly cost benefit analysis is critical for making the case to invest in models of meaningful community engagement.

Independent cost benefit analysis of a Connected Care Navigator service in Birmingham, conducted by Apteligen[2], demonstrated that cost improvement can be made for commissioners as a result of interventions offered by our Community Navigators. The analysis demonstrated a net cost improvement of between £1,956.86 and £9,812.73 per person (dependent on need). The majority of savings were attributed to the local authority through benefits from secured tenancies; improved personal care; fewer missed appointments and reduction of falls at home, however in an integrated system, these clearly benefit the health service too.

[1] Knapp M et al (2011) Building Community Capacity: Making an Economic Case. LSE

[2] Apteligen data (April 2014) analysing the cost improvement of five cases based on three months prior to accessing the service, three months of support and three months after.

What, if anything, would you have done differently?

The project was limited by time, if we had more we would have engaged with more people, but we are happy with how the project ran within the resources available.

Who is the contact for more information?

Sarah Woodhouse, Head of External Affairs, on 0207 481 7655

How were people told about the difference their participation had made?

Our Community Researchers were represented on the steering group (two members), and were also part of a network of Community Researchers across the country, who were regularly kept informed of the outcomes from this work and other projects. Local residents were kept informed through letters, public meetings and the local press.