Do Partnerships Deliver for Service Users University of Glasgow Older People Researching Social Issues SURE (Service Users Research Enterprise) Central England People First

Study objectives to determine the outcomes that service users and their unpaid carers want from services to assess the extent to which health and social care partnerships deliver the outcomes that service users value to determine the features of partnership working that deliver the outcomes that service users and their unpaid carers value to refine the initial interview schedule into a generic user-defined service effectiveness tool

Design 230 interviews with: older people, mental health service users, people with learning disabilities 15 partnerships in England and Scotland interviews carried out in partnership with user researchers – OPRSI, SURE, CEPF

SPRU – outcome types MAINTENANCE – supporting an acceptable quality of life PROCESS – the way in which support is delivered CHANGE – the result of tackling barriers to achieving quality of life or reducing risks

Quality of LifeProcessChange Feeling safe Having things to do Seeing People Staying well Living life as you want Living where you want Dealing with stigma Listened to Choice Treated as an individual Reliability Responsiveness Improved confidence and skills Improved mobility Reduced symptoms

Key Findings Service users valued Holistic services that met social, emotional and physical needs and built confidence Easy access to support when needed, including out of hours and weekends Support from specialist services A say in the nature, timing and location of service provision Good relationships with individual staff Good communication between staff / agencies

Mental Health Interviewees reported that services kept them alive, out of hospital and well Responsive, accessible services were vital in an emergency and helped people feel safe Social contact with staff and other service users was important for emotional and social support, dealing with stigma Activities gave a structure to the day and helped users stay well

Learning Disability People with well resourced, individualised packages of support reported a good qol Advocacy was important for getting good support Integrated services generally met the health needs of users Relationships with staff were very important to quality of life Choice, independence and opportunities to live a ‘normal’ life were valued Carers appreciated the one-stop shop and improved communications and responsiveness of their services

Older People Partnerships delivered change for older service users Supporting quality of life was more difficult – achieved in proactive, nurturing services Home care was problematic in all sites Fluid interventions paced to service user worked best Safety was a key issue for most older people Services played a vital role in reducing social exclusion

Key drivers Single point of contact Improved communication Holistic care Responsiveness of services Non-discriminatory practice Having a say Reduced social isolation

Barriers Discontinuity of staff Availability of information Availability of transport Time limited services Inequities

Key features of partnership Related features of services Outcomes delivered Co-location of staffProviding a single point of contact, improving access and communication Process outcomes especially responsiveness Quality of life outcome: feeling safe Multidisciplinary team Providing holistic care Change outcomes Quality of life outcomes Process outcomes Specialist partnershipProviding specialist, non-discriminatory treatment Process outcomes especially being treated with respect Extended partnershipProviding access to other agencies, and partnership with service users Quality of life outcomes including activity and contact with other people Process outcome: having choices

Practice implications Commissioning and contracting needs to respond to the outcomes defined by service users Partnerships should be delivering on all the outcomes identified Outcome focused monitoring should be the key component of quality assurance Links with other statutory sectors, eg housing, transport, and with voluntary and social enterprise can help partnerships work creatively on desired outcomes