A Sure Start LAA Pilot for Older People Brighton and Hove City Council

Sure Start for Older People in Brighton and Hove A new range of local services, opportunities and choices for older people and their carers Two pilot neighbourhoods – 8,000 older residents Brighton and Hove Council, Primary Care Trust, Age Concern, Older People’s Council, the Pensioners Forum, the Pensions Service, Neighbourhood Renewal and a range of voluntary sector partners A ‘Sure Start’ approach : universal & additional, whole systems approach, enhanced services and opportunities, built on participation and new forms of governance Roll-out practice across city and lessons for adult/other service areas

Why? Older people themselves know what they want and need, they’ve told us and should be listened to We have to do better – current services not coping in face of demographic challenge, embedded inequality and pressures on commissioners & providers National drive for shift of thinking and investment – need to demonstrate effectiveness (for service commissioners as well as older people themselves) of local solutions and practical ‘low level’ services

Principles - How Universal but targeted on ‘emerging needs’ Increasing information, choice and opportunity and meeting needs that people identify as most important Older people’s voices & involvement – devolved decision making & governance (c/f locality/G.P. commissioning) Older people themselves as workers, contact points and ambassadors

Principles - How Whole systems – beyond health and social care Through existing community networks and groups – community development, volunteers and building local capacity A ring fence for prevention Building a sustainability strategy Potential to devolve programme design & commissioning to locality level – resourcing participation and community governance

Strategic Aims To enable older people to live healthy, independent and fulfilled lives To demonstrate the effectiveness of new approaches to a more flexible, user led service

Outcome and Action Improve information and choice for older people enabling them to speedily access the services they need and identify as most important Recruit, train and support volunteers (especially older volunteers) as ‘new front line’ for information, service access, healthy lifestyle advice, promoting ‘independence’ options etc. Self assessment pilot

Outcome and Action Improve the health and well being of older people and reduce premature mortality rates and inequalities in rates (focus on key risk factors – heart disease, strokes & related diseases, smoking, diet, physical activity) Range of primary health services available at local level – dietetics, active for life, chiropody, health checks, ‘health trainers’ programme, health service ‘navigators’

Outcome and Action Reduce the number of people admitted to hospital as a result of a fall Recruitment of falls prevention advisors to local teams in each area – exercise groups, health promotion, education, staff and volunteer training

Outcome and Action Better supporting the contribution of carers and maximising their own quality of life (to include focus on older people who are themselves carers) Partnership with Carers Centre to identify hidden carers, develop local support responses and offer enhanced casework support service in localities

Outcome and Action Improve older people’s access to homes of good quality suited to their needs, wishes and changing life circumstances and to promote their confidence and safety in the wider community East Sussex Fire and Rescue Service partnership with newly commissioned HomeWatch service– home safety and security audits, improvements and adaptations service, energy efficiency advice and grants information/advocacy, fuel debt support

Outcome and Action Promote and extend access to and take up of opportunities for education, employment and occupation for those who wish to work, learn and volunteer Partnership with Adult Learning Team – outreach workers in each area re. education and employment opps. for 50+, ‘return to work’ programmes, co-ordination of local learning provision through range of providers

Outcome and Action Improve utilisation of services & opportunities to maximise income and access to relevant benefits, grants and other financial support partnerships with Pensions Service and welfare benefits team – outreach and home service for pensions and benefits M.O.T., advocacy, debt management. Capacity building in local teams.

What else? Fund for local services and solutions Inter-generational projects Promoting and celebrating older people in local communities Hard to reach – positive action plan Influencing re-design of services and ‘vision’ for commissioning older people’s services Gathering evidence as to ‘what works’ for older people (and re-interpreting that to professionals)

The Core Team Leader Volunteering programme Community development Building local teams with local identity Integrating with Neighbourhood Renewal and working through community organisations and existing infrastructure Capacity building and developing new governance structures

Delivery on a shoe string £185,000 Partner contributions – staff, expertise, training, additional capacity Bending resources – Community Development Commissioning, Neighbourhood Renewal, Equal programme, health trainers programme, LPSA, carers grant etc Local priorities and realistic delivery against national targets

Using the LAA framework Is LAA just a new set of funding and reporting arrangements A planning tool A ring fence for prevention and lever for service transformation? Prompts creative contributions and collaboration, firms up partnership Vehicle for setting out strategic partnership’s business agenda Potential to influence mainstream Improved GO/local relationships

But….. It’s tiny (ASC spend re. older people £28 million +) LAA and this approach not yet centre stage Changing cultures and intransigence of big organisations Prevention loses out to acute priorities You have to work twice as hard to convince others of the value of innovation Too early to tell on outcomes – realistic timescales “A shift in the centre of gravity of spending” ?