The Challenges of Co-production Erik Scollay, Assistant Director: Social Care, Middlesbrough Council 27 th November 2015

Life in Middlesbrough….. Middlesbrough is the local authority with the highest proportion of its neighbourhoods in the most deprived 10% of neighbourhoods nationally (IMD, 2015) The state of health of our population is significantly worse than the England average. Life expectancy is shorter than the England average. Life expectancy is 15.9 years lower for men and 10.8 years lower for women in the most deprived areas of Middlesbrough than in the least deprived areas. Smoking related deaths are higher than the England average Alcohol related hospital stays are higher than average..

Where we were and where we are going…. In the past: we had a strategy, we did some assessments, we commissioned some things…..it was never quite there. then… Financial austerity brought unprecedented, on-going challenge. the Care Act 2014 brought new duties (and increased responsibilities to carers).

The challenge for Middlesbrough Council April 2013 – Executive approved Phase 1 of the Council’s change programme to meet the challenge of unprecedented financial contraction and maximise the Council’s contribution to the 2020 Vision. The first rolling three year plan ( ) was designed to address the then gap of £67M. The Change Programme delivered £15M of savings in 2014/15. The 2015–2018 MTFP has now been established with savings of £56M required for the period. The Council budget has reduced by 40% over the last 5 years We will look different and deliver differently.

Future = Transformational Change We will: Find merit, virtue and opportunity in financial necessity Understand what works Focus on prevention, early intervention and re-ablement Embark on a “new conversation” with citizens Work alongside all of our partners to ensure that we optimise the effectiveness of our joint offer – blurring of boundaries and roles

Strategic Planning for Carers Developing from Summer 2014: a new methodology for a new strategy. Themed conversations based on: “what are the aspirations of carers”, “what is life now for carers” and “how do we get to where we want to be”? Themes leading to 12 outcomes; outcomes shaping measures of impact Outcomes and measures informed our new plan; “A Strategy to Support and Value Carers in Middlesbrough 2015 – 2019”

Outcome 1 – Carers have improved health and wellbeing. - the achievement and/or move towards the maintenance of physical fitness and mental stability. Outcome 2 – Carers feel supported and valued. - carers need to be recognised in their role as carers as this is important to their self-esteem and the maintenance of strong families and communities Outcome 3 – Reduction in the numbers of carers who experience financial hardship. - reducing financial hardship and related systemic barriers can only benefit the carer, the cared for person and the wider family and community. Outcome 3 – Reduction in the numbers of carers who experience financial hardship. - reducing financial hardship and related systemic barriers can only benefit the carer, the cared for person and the wider family and community.

Outcome 5 – Carers have increased opportunities to participate in training, education, volunteering and employment. - important to maintain carers wellbeing, stability and promote participation in normal life. Outcome 6 – Understanding and appreciation of the role of carers in Middlesbrough. - to help to add value to local communities by benefiting carers and offering more opportunities to be a part of Middlesbrough. Outcome 7 –More carers have their needs met. - carers receive the right help and support at a convenient time to ensure that they continue their role. Outcome 8 – Increased range of high quality, appropriate and accessible information, advice and advocacy. - information, advice and advocacy available and tailored to carers needs.

Outcome 9 – Improved support infrastructure for carers. - carers receive the appropriate services and support and can influence what is provided and ensure gaps are filled. Outcome 10 – Improved health and social care pathways for carers. - the needs of carers are identified at an appropriate and early stage which allows them to receive the right support to meet their needs. Outcome 11 –Improvement of understanding so that support is provided to carers at the right time. - procedures and mechanisms are in place to help identify carers and their needs as early as possible. Outcome 12Increased collaboration to shape service planning and effective use of resources. - carers and those who are cared for are fully engaged by commissioners and providers.

Future work…. Governance and strategic delivery provided by: Wellbeing, Care and Learning Transformation Board Middlesbrough Strategic Carers’ Partnership – to oversee and monitor implementation of the strategy and support implementation of the 12 agreed outcomes. Live from January Middlesbrough Health and Wellbeing Board