1. SDCCG Outcomes Framework Project Workshop 2 (Front Line Staff and Managers)

2. Who Are We? CORC Vision That what is important to children and young people is at the heart of service provision and planning. Mission To foster the effective and routine use of outcome measures in work with children and young people (and their families and carers) who experience mental health and emotional wellbeing difficulties.

3. Who Are We? Common Room Common Room is a consultancy that promotes collaborative practice and advocates young people’s views and experiences. We start with what we have in common. Whoever we are - young person, adult, practitioner, policymaker - we all want to be heard, to have our views and experience valued and to feel in control of our lives. We all just have different perspectives and experiences of the same situations and all have expertise to share. We believe it’s better to work together to find our common ground, use our collective expertise, and be partners in change

4. An Outcomes Framework, endorsed by commissioners, clinicians, service users and service providers and comprising The Integrated Delivery Outcomes and User/ Patient Outcomes and Outcome Goals identified in Phase 1 together with A set of high level Impact Outcomes that relate to children and young people’s goals from intervention A set of indicators by which to measure progress towards achieving outcomes across all areas of children’s services A performance management framework to support meaningful analysis, interpretation and application of data in driving forward service improvement Improved skills of commissioners and partners in developing outcome based commissioning A report highlighting outcomes, learning and risks Deliverables of the SDCCG Outcomes Framework project CORC will work with South Derbyshire CCG and local stakeholders to deliver the following:

5. The key stages of the project are:

6. This stage is iterative and will begin after the Mapping and Baselining stage What data is reported to who, when and in what format Facilitated ‘trial’ performance management meetings evoking CORC’s MINDFUL approach This stage is iterative and will begin after the Mapping and Baselining stage What data is reported to who, when and in what format Facilitated ‘trial’ performance management meetings evoking CORC’s MINDFUL approach Indicators which will measure progress towards achieving embedded outcomes Facilitate workshops on two levels: Broad based involving service providers and data managers aiming to draw on different perspectives and raise awareness Strategic level with service managers and commissioners to hone a list of most meaningful indicators Enlist Common Room Consulting to support engagement with local service users Indicators which will measure progress towards achieving embedded outcomes Facilitate workshops on two levels: Broad based involving service providers and data managers aiming to draw on different perspectives and raise awareness Strategic level with service managers and commissioners to hone a list of most meaningful indicators Enlist Common Room Consulting to support engagement with local service users Based on the work already done in Phase 1 and building from the defined Impact Outcomes Use research on best practice and learning from others in the CORC collaborative Facilitate workshops involving service providers, commissioners and service users Review workshop outputs and make proposal for refinement and sign off by Integrated Commissioning Board Based on the work already done in Phase 1 and building from the defined Impact Outcomes Use research on best practice and learning from others in the CORC collaborative Facilitate workshops involving service providers, commissioners and service users Review workshop outputs and make proposal for refinement and sign off by Integrated Commissioning Board Mapping who is currently collecting what, how and where this is being flowed to and what reporting formats are in place. Conducting Interviews with stakeholders to give a whole systems view Mapping who is currently collecting what, how and where this is being flowed to and what reporting formats are in place. Conducting Interviews with stakeholders to give a whole systems view Meeting with CCG Representatives Meeting with existing Outcome Framework Task and Finish Group Agreeing on appropriate communications approach Meeting with CCG Representatives Meeting with existing Outcome Framework Task and Finish Group Agreeing on appropriate communications approach PROJECT SETUP MAPPING & BASELINING IDENTIFYING OUTCOME GOALS FOR THE IMPACT OUTCOMES IDENTIFYING A SET OF INDICATORS BY WHICH TO MEASURE PROGRESS TOWARDS ACHIEVING OUTCOMES DESIGNING A PERFORMANCE MANAGEMENT FRAMEWORK

7. Aims of today Introduction to the project, CORC and Common Room The Outcome Goals as they currently stand How can we measure these? Outcome Measures – practical examples Who needs to see what, when and how?

8. The voice of the child – why it is important… Facilitate a collaborative approach Glean information which may have been missed Facilitate reflection (at both individual and service level) No decision about me, without me (DofH 2012) Future in Mind (NHSE 2015)

9. Why do we need an outcomes framework? Not just assuming we are doing the right things To understand how effective a service is being To understand need and where resources are best placed To make sure we have the young persons perspectives

10. The Outcome Goals What do you currently collect that can answer these Outcome Goals? Are our suggestions accurate?

11. A quick introduction to a few measures… Important Note: These measures are being shown as a brief introduction to the measures CORC feel fit this type of framework. These particular measures, although developed in clinical settings can transcend service boundaries and give a global indication to the achievement of the Outcome Goals. It is not recommended that these measures are used without further indepth training.

12. Goal Based Outcomes “ … a way to evaluate progress towards a goal in clinical work with children and young people, and their families and carers. They simply compare how far a young person feels they have moved towards reaching a goal they set at the beginning of an intervention, compared to where they are at the end of an intervention” (Law, 2011)

13. Goal Based Outcomes Helps build a strong therapeutic/ working alliance – – Helps track the specific goals the service user wants to address – Tool to aid and focus discussion – all parties are clear about what the agreed ‘contract’ of intervention is Applicable to all interventions Relatively popular among practitioners – often clinically relevant, resource light (you only need pen and paper) and quick to implement

14. ORS/SRS Should always be used in conjunction with each other Applicable to all direct work Session by session Multiple languages

15. ORS

16. SRS

17. ORS & SRS Graph

18. SWEMWBS

20. CHI-ESQ – What is it? Experience of service feedback questionnaire 12 items Parent and Self-Report (9-18yrs) Gives indication of satisfaction with service Additional free text questions allow for collection/ analysis of qualitative data alongside quantitative responses Collected at 6 months or case closure (whichever is sooner); then annually if still in service

22. Child CHI-ESQ n=45 (30%) Parent CHI-ESQ n=37 (25%) Erinsborough Rest of CORC Child CHI-ESQ n=471 (11%) Parent CHI-ESQ n=440 (10%) Parent CHI-ESQ Child CHI-ESQ

23. Filling the Gaps… Consider, in your service, where you currently are in terms of collecting outcome data. Then consider what actions you may need to take in order to be able to collect, record and submit this type of data…

24. Service Performance Aggregated Individual Experience Activity Measures (inc. PH Indicators) How it fits together? Individual Outcomes (User / Patient) Which User / Patient outcomes are important to me? I can… I have… I am… Individual Experiences (Integrated Service Outcomes) Direct Measures CHI ESQ GBO SRS S/WEMWBS Process Measures Timeliness Steps Followed / activity completed Which of these measures are most meaningful to our services? What do we already collect? These can be aggregated up into… Population Outcomes We have less … We have more… We are… Improvement here will lead to improvement here…… Current gap? Direct Measures GBO SRS S/WEMWBS Results of these impact here…

25. How to make sure all our work is focussed on achieving outcomes: the Golden Thread The aim of the work that has been done across services and with service users is to get shared understanding and collective ‘buy-in’ on the outcomes we want to achieve. The next task is to make sure this is reflected in strategies, plans and policies, and delivered through everybody’s actions The framework should provide a Golden Thread, giving a clear ‘line of sight’ as to how services align around delivering those outcomes: from the level of individual objectives and actions, to team, to service, to cross- service

26. For example… Outcome goals are delivered through practitioners direct work with young people Supervision and team meetings support practitioners in delivering outcome goals At service level managers review overall service impact At area level, commissioners and managers consider how services are collectively impacting on local outcome goals Shared use of feedback and outcome tools, e.g. Goals, ORS/ SRS, support this being done Information from feedback and outcome tools as well as individual activity data together with clinical expertise and other contextual info Look at different types of data; consider benchmarks with similar services; consider service design and support; research and evidence about best practice; mix of interventions etc Look across the whole local system to ensure resources are deployed in the best possible way to achieve outcome goals

27. Who needs to see what / when / how? Example Golden Thread Child, Young Person, Parent / Carer Front Line StaffTeam LeaderService ManagerSMTCommissioner Individual Outcomes Relevant information at every meeting Accessible as and when needed Case load outcomes results Weekly and monthly Monthly cases on trach / not on track Individual Experience Monthly Case load experience Monthly Service Experience Monthly Quarterly Service Performance (activitry)

28. In groups please consider the types of measures we have discussed and begin to populate the Golden Thread in front of you; – Are the stakeholders right? – What are the key categories of information? – Who should see this information? – How often do you think different stakeholders should be seeing this information? – What methods do you think will be best? We will take feedback and populate as a whole group. Who needs to see what / when / how?

29. Child, Young Person, Parent / Carer Front Line StaffTeam LeaderService ManagerSMTCommissioner Individual Outcomes Case load outcomes results Service outcomes results (aggregated) Individual Experience Case load experience Service Experience Service Performance

30. Next Steps Further engagement with CYPs Strategic Workshop 29 th Jan ‘Mock’ performance management meeting (test of measures) Final report and recommendations

31. More information http://www.corc.uk.net/resources/measures/ Sally Marriott, North East Regional Support Officer: 07776760890 sally.marriott@annafreud.org