Sixty Second Interview with Victor Adebowale
By Maria Ahmed
Lord Victor Adebowale is chief executive of Turning Point. The social care charity has recently put forward a new “blueprint,” Connected Care, that aims to bring health and social care services together.
How did the model of Connected Care evolve, and how does it work?
Joint research, conducted by ourselves and IPPR in 2004, identified that people with complex needs were being failed by the government regardless of new strategies and public service reforms. Many people who need to access health and social care services find themselves excluded for a number of reasons. People with complex needs are more likely to come from areas of deprivation, for example children in poor households are three times more likely to have mental ill health than others. In addition, some people do not have access to primary and secondary care and the quality of services they receive does not meet their needs. Another issue is that many agencies work for their own core services such as mental health or drug misuse but there is not much crossover when it comes to someone who has complex needs. The Connected Care model is designed to provide an interlocking, bespoke range of services which directly reflect and respond to the specific needs of the individuals and communities they serve. We see this as an innovative approach to delivering health and social care against government proposals as laid out in the Green Paper on social care and the White Paper on community health and social care services.
A lack of joined-up working between health and social care has been highlighted as one of the major problems in services for people with learning difficulties. How would Connected Care help this service user group, and what other groups would benefit from this specific model?
Connected Care is not just for those with a learning disability, it is designed to bring together mental health, substance misuse, learning disability and other specialist services for those with complex needs, offering universal support on health and care as well as advice on housing, education, employment and benefits. Someone with mental health problems or a learning disability would be engaged immediately before the only assessment they will need, with a specially trained Connected Care generalist. After one interview all relevant professionals will have access to the person’s information, with their consent, and the generalist will be able to bring in the specialist help required as well as acting as a point of engagement for practical issues such as housing and benefits.
What are the main challenges in taking a model like this forward, and what obstacles prevent health and social care services working together, especially in terms of funding streams?
It is common knowledge that current commissioning regimes are inflexible and not inclusive. Connected Care would task commissioners to find the right balance between prevention, meeting low level needs and providing intensive care for those with high level needs. It would bring together two kinds of primary care commissioning resources. Firstly, Connected Care services would be commissioned to provide primary care in the same way that other agencies have been. Secondly, it would provide services for the sorts of complex needs that primary care trusts and social services already commission Turning Point to provide. It would integrate the funding streams for health and social and also neighbourhood budgets to ensure that what is being delivered is value for money.
Turning Point has been running a pilot of Connected Care in Hartlepool since May. How is this going, and when will it be evaluated? Are there any plans to roll this out nationally?
Around 600 people including local residents, service users, carers, community workers, professionals and commissioners, working alongside a broad range of agencies including Hartlepool Social Services and Housing are involved in the project. It integrates funding streams across the neighbourhood, health and social care budgets as much as possible in order to ensure there is a cost effective and joined up approach in every part of the delivery. As part of the model we have developed the Connected Care Audit which is a new model of community consultation. It is carried out by the local community and assesses how existing service structures are working and where improvements could be made. This pilot programme is being evaluated by Durham University and is supported by the Department of Health and the Social Exclusion Unit. We will be evaluating the project in early 2006, and will be using our findings to make an even stronger case for the advantages of using this model on national level. We are very excited about this project and see it as another step towards making episodic and fragmented care for people with complex needs a thing of the past.