Saving the human race – delivering health and care beyond the walls

Introductions and aims of the session – Chair, Elaine Meade Understand key success factors from early years improvement work Understand how Asset Based Community Development can help focus improvement work Explore techniques for engaging communities and families in the improvement work

Judith Ainsley

To make Scotland the best place in the world to grow up in by improving outcomes, and reducing inequalities, for all babies, children, mothers, fathers and families across Scotland to ensure that all children have the best start in life and are ready to succeed Ambition

Our context Community Planning Partnerships - Partners work together to achieve positive outcomes for citizens (5m) Multi agency approach Children from 0-8 Health inequalities Social inequality 170,000 children live in poverty Early Years experience has a substantial impact on outcomes

The Early Years Collaborative will been building will & generating ideas for a while! Brain develo- pment Perry Pre- School Ed (2004) GIRFEC (2004) CMO report (2007) Early Years Frame- work (2008) Early Interv- ention (Allen 2010) Joining the Dots (2011) Collabo- rative (2012) Knowing is not enough; we must apply Goethe

Early Years Collaborative -9 months to 1 year 1 year to 30 months 30 months to Primary school Leadership 5 – 8 years Scotland – the best place in the world to grow up

Stretch Aims 1.Positive pregnancies which result in the birth of more healthy babies by end 2015, through a reduction of 15% in the rates of stillbirths and infant mortality. 2.85% of all children reached all of the expected developmental milestones at the time of the child’s 27 ‐ 30 month child health review, by end ‐ % of all children reached all of the expected developmental milestones at the time the child starts primary school, by end ‐ % of all children in each Community Planning Partnership area will have reached all of the expected developmental milestones and learning outcomes by the end of Primary 4, by end-2021

The story so far Year 1 practitioners chose tests of change and became familiar with the method Year 2 we identified key changes Now have 40 Pioneer Sites Faster learning for scale and spread 4 Learning Sessions Learning Session 5 on 9 and 10 June

Importance of using our Assets Massive change across the public sector Scarcity of economic resources Health and Social Care Integration Children and Young People’s Act Lots of improvement activity All working to improve things for the same children and families

Adapted from Albert Hirschman, Against Parsimony diminish grow Economic resources diminish with use money materials technology Natural resources grow with use relationships commitment community

Video ABCD in the Early Years Collaborative

Angela Glassford – Head Teacher ABCD – Assets Based Community development Shared understanding of asset based work - what this looks like in your context (values and approach) What did we set out to achieve and why? What was the plan and how things happened? Sharing some of the specific ways in which we engaged with children and their families to develop both individual and community assets (our change ideas) How this enabled us to deliver better health and wellbeing outcomes and experiences for the children in our locality How this fitted with our local priorities? The infrastructure to support it. How we plan to spread and sustain this approach as we move forward

Early Years Strategy Recognised need to focus on early years Multiagency responses Workshops to develop model Culture Change Family Focussed Approach £6.8 Million investment

Delivering! Salutogenesis Growing health and wellbeing

Locality Model Ferguslie and Linwood (Pathfinder Areas) Core Teams in each locality Mapping of existing community assets Strengthening of links between existing services, including third sector Integrated practice across the disciplines Building universal services and increasing community capacity Targeting support in partnership with families

What do families tell us? Someone to look at my whole family and not just judge me Someone to listen to me…not numerous people I have to tell the same thing to again and again Someone to help me see what my problems are and with support, how I can solve them Someone to tell me when I’m doing well…this really worked! More support with mental health More time with someone helping me Contact with others so I don’t feel alone

Core Team Structure Locality Manager Family Core Team Co-ordinator Family Wellbeing Worker (across both areas) 3 Family Keyworkers Admin Worker

Evaluation criteria Family centred Responsive early intervention Integrated working Flexible delivery of services Adding value Minimising barriers Scalable Measured against shared goal setting

Giving Our Children the Best Start in Life – A Strategy for the Early Years in Renfrewshire John Trainer Angela Glassford

Sustain and Spread “It’s not what you do it’s the way that you do it.....” Link back to families as the driver of change and development Outreach Organisational change Convert and enable Security of funding commitment Political will

Driver Diagrams

Values Knowledge for Improvement Psychology Appreciation of a system Theory of Knowledge Understanding Variation Knowledge for Improvement Subject matter Knowledge

Where in the System of Profound Knowledge are we learning? Appreciation of a System Understanding Variation Theory of Knowledge Psychology Values

What is a theory? A description of our best understanding about why things are the way they are Theories/beliefs in other contexts? Economics – game theory Biology - theory of evolution Physics – string theory Metereology – chaos theory Assets Based Community Development…?

How is a theory different from a belief? A theory can be tested scientifically Theories are predictions of the outcome of future events Theory is the starting place for generating new knowledge

Project Driver Diagram do studyact plan

What do we believe about why things are the way they are? Evidence – what objective evidence have we collected locally or is available to us through the relevant literature? Local subject matter experts – people who work at the frontline who experience the system day to day and have strong experiential beliefs about where change is needed

Some guidance on creating a driver diagram Start with the outcome in mind – develop an aim statement that reflects the desired future state Primary drivers should be nouns that reflect the key leverage points in the system of interest from three areas: 1.Structures – physical, financial, administrative, management and improvement, delegation and accountability 2.Processes – workflow of the system, how things are accomplished 3.Operating norms – written and unwritten rules that govern behaviour

Some guidance on creating a driver diagram Secondary drivers must be tangible things where action can be taken on the system Change ideas should link directly to secondary drivers and should exhibit these characteristics: 1.Specific - each change idea needs to be clear and concise and it must be obvious how its introduction is different from the status quo 2.How to - each change idea must include a statement about how and where it will be put into practice within the system

So can we use this approach today? Table time to develop your own aim – 5 minutes

TRIZ Change ideas - using Triz as a mechanism to get the elephant in the room and the change ideas on the table!

How could we STOP Assets Based Community Development? 5 minutes table work to get ideas – be as radical as you can be! Make a list of all you can do to make sure that you achieve the worst result imaginable with respect to ABCD

From your list – cross out everything ABSOLUTELY not possible 5 minutes Go down this list item by item and ask yourselves,: Is there anything that we are currently doing that in any way, shape, or form resembles this item? Be brutally honest to make a second list of all your counterproductive activities/programmes/procedures

So what are you left with? 5 minutes – feedback Go through the items on your second list and decide what first steps will help you stop what you know creates undesirable results Are these your secondary drivers or change theories to work on?

Group your change ideas at your table feedback

Now populate the Driver Diagram What will be different at the level of: ????

SUMMARY Next steps What are you going to do by next Tuesday?