Launch pad to higher standards

A three-star accolade wasn’t the only thing to stem from the 22
councils judged as “excellent” in the comprehensive performance
assessment at the end of last year. Better, perhaps, was the chance
to experiment with the accompanying new freedoms and flexibilities
granted by the government.

To garner this into a co-ordinated work programme, the Local
Government Association and the government came up with the idea of
an innovation forum to develop, explore and test new ways of
working. The forum held its first meeting in May and expects to
meet every four months or so – the next one will be in October.

Phil Swann, LGA director of strategy and communication, says: “The
idea emerged out of discussions we had with the government this
time last year when comprehensive performance assessment was being
proposed. We wanted those excellent authorities to have a chance to
develop genuinely new radical ways of doing things.”

Initially, the authorities identified four themes that would
improve the quality of services locally: public service
integration, school improvement, community safety, and care of
older people.

“These are four challenging areas of public policy where there’s a
need for everyone to do better,” says Swann.

There is one lead local authority for each theme and the remaining
18 councils will sign up to at least one to help develop a
programme of action that will be carried out in their areas.

“Some things won’t work and we need to be grown up about that,”
says Swann. But where they do, he says, the government is committed
to making these freedoms available more widely as a tool for
improvement rather than a reward for success. “If what the forum
does is shown to work, the government is prepared to extend it – so
it’s not an exclusive club.”

Care of older people

The most radical idea is being explored by Kent Council. It
proposes to reduce hospital admissions and delayed discharges of
older people by commissioning health and social care services for
older people from a single point – led, crucially, by social
services rather than health. Services included within this single
commissioning point would be: acute care, intermediate care,
community hospitals, residential care, nursing home care, housing
support, occupational therapy and domiciliary and day care.

The NHS, Department of Health and the Treasury are considering the
proposition. When Kent and the other authorities that sign up to
the proposal have the go-ahead – hoped to be by the next forum
meeting – they will start a pilot.

Episodes of acute care in a continuing care bed in hospital are
much more expensive than community care packages and preventive
services, says Sandy Bruce-Lockhart, leader of Kent Council. The
cost of keeping someone in a continuing care bed in hospital can be
as much as £1,500 a week, compared with about half that in an
intermediate care home, and even less if they are cared for in
their own home. The proposal aims to save money by diverting
investment towards more cost efficient preventive services,
intermediate care, community care and treatment in primary care
settings, rather than in hospital.

“We are trying to work hard on the admissions side while the
government has been looking hard at the discharge side and coming
up with fines,” says Bruce-Lockhart. “That’s because they are
looking at hospital capacity, but the most important thing isn’t
necessarily the speed you take people out but the number of
admissions that go into hospital in the first place.

“It will be in our interest to speed people through or prevent them
going into hospital in the first place, giving us more money for
preventive care.”

The proposal includes plans for local authorities and participating
primary care trusts to receive financial benefits for each acute
hospital admission that is avoided – money they will be able to
reinvest in alternative services.

There are wider issues in that preventive services, earlier
intervention and rehabilitation require partnership working beyond
that of health and social care services. To be successful it needs
the whole spectrum of local public services, including transport,
police, fire, housing, leisure and benefits, and the idea is that
local government is well placed to make this happen.

The benefits to older people will be that services will put their
needs first rather than those of commissioners and providers.
Ultimately, it should ensure that older people can live more
independently for longer and enjoy a better quality of life.

Creating safer communities

The London Borough of Camden is the lead authority for the
community safety theme, tackling drugs, antisocial behaviour, youth
offending and street crime. The theme will look at
information-sharing between agencies, the lack of financial
incentives for local authorities to invest in early intervention
community safety work, the involvement of young people in crime as
victims and perpetrators, and ways to reduce fear of crime.

Dennis Skinner, Camden’s assistant chief executive, says the main
hindrance to successful community safety work is bureaucracy. He
wants authorities to have more freedom to set local targets rather
than having to concentrate on nationally driven targets and to be
monitored less. He says: “Some of the monitoring requirements are
ridiculous. For the community against drugs fund we had to send
copies of every invoice, some for £10, to the government
office for London. We spend too much time on monitoring and on
monitors monitoring the monitoring, and not delivering.

“In the first four months of this year our drug action team had to
produce 15 reports for various parts of government. We are tying up
resources on filling in schedules.”

Although early intervention schemes can be cost effective and local
authorities are often best placed to deliver them, there is little
financial incentive for councils to invest in them, he says. “They
are long-term and if there are efficiency savings down the line it
will probably be in another agency such as the courts. We want the
government to look at ploughing the money back into the local

Information sharing and data exchange about community safety issues
between partners is often poor because of anxiety about data
protection issues. “Why is it we find it a problem to share
information? We need to create a culture of doing this,” says

So does he envisage these ideas coming to fruition? “Generally
there’s a feeling that it’s probably easier to make some quick
progress in this area than in some of the others. I can see the one
pot of money and less monitoring requirements actually

He is keen to ensure that there is some significant progress before
the next innovation forum meeting. “Many of these things should be
rolled out to all councils as quickly as possible. In some cases
there may be a need to pilot some ideas but wherever it’s feasible
the additional freedoms and flexibilities shouldn’t just be for
‘excellent’ authorities. If they make sense we should be pushing
for them in all authorities.”

The theme’s proposals include:

– Setting up a single pot of money for community safety that is
allocated over a three-year period rather than yearly. This should
enable expenditure to be moved from one year to the next.

– Freedoms and flexibilities to be available to all agencies on the
crime and disorder partnership, not just the “excellent”

– Creation of an Invest to Prevent budget for “excellent”

School improvement and early years

Blackburn with Darwen is leading on school improvement and early
years excellence, and the 12 new children’s centres planned are
examples of the sort of proposals the forum is looking at.

Aimed at under-fives and their families, these centres will provide
child care and support services, early years education, health
services, family support services, all nursery school provision and
adult learning. The first nine centres are due for completion by
March 2004 and the rest are expected to be completed during 2004-5.

“It’s bang in line with the government agenda for early years
provision,” says Peter Morgan, the council’s director of education
and lifelong learning and lead officer for the forum on this theme.
“Early years is about having intervention at the earliest stage of
a child’s life and putting in the support from a variety of
agencies so that we don’t have to remedy the situation later.

“At the moment strategy is reactive, and it needs to be proactive.”

There has been progress on the early years child care strategy
nationally, but access and choice remain patchy for many families,
particularly those from disadvantaged areas. The proposal is
intended to allow councils to take a lead role in developing
innovation through integrated children’s centres.

“Stuck schools” will also be tackled within the school improvement
remit. These schools are ones that fail to improve under existing
strategies and pupil numbers drop as parents remove their children.
Consequently, the schools end up taking on children who have been
excluded or have difficulties. There is at least one stuck school
in every local education authority and they tend to be in the most
socially excluded communities, says Morgan.

Proposals include greater flexibilities around funding to enable
“excellent” local education authorities to look at new ways to help
stuck schools, as well as more collaborative work with other
agencies including Ofsted, the Department for Education and Skills
and the Learning and Skills Council, particularly over

Public service integration

The aim of this proposal, led by Sunderland Council, is ambitious:
to develop the integration of a range of services so that local
people have a choice about how, where and when they access them. At
the lowest level this could involve “one-stop shops” for various
services, but more ambitious plans could involve, according to the
proposal document, “a new breed of services which would not be
attributable to any one existing agency – not unlike the youth
offending service”.

To do this, several barriers that stand in the way of local
solutions to problems need to be removed. Issues to be addressed

– Developing joint strategies relevant to local

– Establishing a single set of key performance indicators, targets
and defined outcomes serving all local and national

– The flexibility to share data and address confidentiality.

– Establishing joint budgets for services across public

This proposal has the potential to contribute to the seven shared
priorities for improvement in key services agreed through the
central local partnership, including: raising school standards,
improving quality of life for young, old and families at risk,
promoting healthier communities and building safer communities.

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