1. Welcome to the ImROC Fourth Annual Conference Julie Repper Director – ImROC Recovery Lead – Notts Healthcare NHS Trust

2. Thank you  To speakers – from a wide range of organisations, all committed to improving the lives of people with mental health problems.  To delegates – who support ImROC and share their views and experiences with us so that we can remain credible, immersed in the wisdom derived from practice and lived experience, constantly pushing for progress, developing our expertise and pooling it with those who we support to coproduce contexts in which people can really Recover meaningful, contributing and valued lives.  To ImROC consultants – an ever expanding collective of experts from various backgrounds with a wide range of experience. Always open to sharing their wisdom, more importantly willing to learn from others, and most importantly able to facilitate recovery focused conversations that result in real change.

4. What is ImROC  A collective of individuals, organisations, communities all working with communities to develop systems, services and cultures that support Recovery and Wellbeing

5. What has ImROC achieved? Worked with 40+ local services, raising awareness of the fundamental importance of life: work, housing, roles and relationships. Coproducing tangible changes  Facilitated the development of 600+ Peer Support workers – people with lived experience recruited, trained, placed, and supported, employed in local mental health services  Helped establish 40+ Recovery Colleges in England, Ireland, Italy, Australia, places where people with lived experience, professionals, carers and others can learn together to construct new meaning from their experiences  Introduced new ways of thinking about the assessment and management of risk - from ‘risk’ to ‘safety’  Reduced the use of physical restraint and forcible medication on acute wards (‘No Force First’) improving quality of care and decreasing staff stress

6.  Supported hundreds of clinical teams to critically assess current practice and develop a more recovery focused culture using TRIPs.  Inspired organisations to think carefully about workforce issues – how to recruit, who to recruit, how to support staff and how to enable all staff to use lived and life experience in their work.  Developing new understandings and practices in coproduction – facilitating constructive conversations across traditional boundaries. New briefing papers for 2016-17 include: Coproduction: learning from ImROC experience Dementia and Recovery Workforce and Recovery The ImROC Improvement Methodology

7. How has this happened? An evidence-based methodology for organisational change I.Knowledge dissemination (Briefing papers) II.A framework for assessment and service planning (‘10 key challenges’) III.Information-based coproduced planning, implementation and review (repeated P-D- S-A cycles) IV.Support shared learning for continuing change (Learning Sets) V.Recovery focused (Transformational) Leadership

8. Knowledge dissemination (Briefing papers)

9. The ‘10 key organisational challenges’ (SCMH, 2009) Creating the organisational culture for Recovery focused change by –  Changing the nature of day-to-day interactions  Offering comprehensive, coproduced learning opportunities for staff  Ensuring organisational commitment at all levels  Shifting understanding of involvement to co-production Improving experience, outcomes and cost effectiveness of services by  Establishing a ‘Recovery Education Centre’  Transforming the workforce (‘peer support workers’)  Changing the way we approach risk assessment and management  Supporting staff wellbeing and resilience  Increasing opportunities for building ‘a life beyond illness’  Valuing, including and supporting family members and friends

10. Our census of Recovery-focused practice Baseline measures on:  personal recovery planning  recovery colleges  peer workers  changing the culture  safety planning  supporting staff

11. What does the data tell us?

12. National census of Recovery- focused practice  Retrospective date: 1 December 2015  25 organisations completed so far  Welcome other replies – see imroc website or email imroc@nhsconfed.orgimroc@nhsconfed.org  Opportunity to facilitate collection of Recovery practice nationally

13. What have we learnt?  Change is possible – even in these difficult financial times – but it must be driven by a strong partnership between people who provide services and people who use services.  Training is not enough on its own! Sustainable change depends on changing the organisation as well as changing staff behaviour ‘on the ground’  Leadership is critical, but leadership is distributed throughout organisations, it is not just at the ‘top’ (or the bottom)  The most powerful lever in change has been a committed Board of Directors and peers in the workforce  Coproduction is central to Recovery, and the Recovery College provides a model of how this works.  Whole system change is as important as organisational change  Routine Recovery outcome measurement needs to be integral to organisational development

14. Refocusing ImROC in the last year  Looking beyond organisational change. Whole system change – building community capacity, integrating primary and secondary care, physical and mental health care, health and social care.  Working with commissioners and providers together with local stakeholders (police, ambulance, housing, education, 3 rd sector) to support coproduced transformation.  Exploring service level interventions that offer something different, are staffed in different ways, build self management skills, draw on untapped community resources.  Learning from learning and physical disability to facilitate personalised, individual packages of support that enable everyone to do the things they want to do. “Gentlemen, we have run out of money, now we have to think”

15. The Direction for 2016- 17  Programme of work needs to address and reflect Task Force recommendations.  Building community capacity – working with commissioners.  Focusing on “Life Beyond Illness’  Continuing to drive culture change within organisations  National Workshops on ‘hot topics’ – peer support, forensic recovery  More Research - Recovery outcome measures, Annual Survey of progress on sites, Working with researchers on multi-centre research programmes,  Expanded training, coaching and mentorship offer with responsive learning sets  Briefing papers planned on Business case for Recovery, Dementia and Recovery, Coproduction and the ImROC Improvement Methodology  New partnerships – NDTi, Open Dialogue, Wales?

16. What are the Challenges?  Transforming relationships, conversations and culture of services and communities.  Shifting from creativity to consistency- from pilot project to mainstream;  Sustaining momentum – old habits die hard especially in times of stress  Doing different things instead of adding new ways of working at additional cost  Demonstrating success in terms that are valued by the establishment.  Continuing to influence policy, NHS England’s implementation of Task Force Report, HEE etc  Sorting out new hosting arrangements for ImROC

17. Today  A full programme focusing on enabling people to “Recover a Life” facilitating meaningful valued lives through more social support.  New ideas, innovations, creative thinking.  Symposia focusing on young people, dementia and families.  More listening than participating – you will need to take key messages back to your places of work to consider how they can influence your practice.

18. Thank you For further information contact Julie.repper@nottshc.nhs.uk OR www.imroc.org