The context
At the request of the ICS, LIPS provided improvement support at system and place level including a peer review at system level as well as tailored support to each of the three place-based partnerships of Berkshire, Oxfordshire and Buckinghamshire. The partnership context for the ICS includes five upper tier local authorities each with their own health and wellbeing board and other place partnerships established over many year.
Important to the place-based partnerships were to develop their priorities, ways of working and focus, including membership and governance.
“We were looking for support in developing our place-based partnerships when we came across this programme.” Dan Leveson, Place Director, Oxfordshire
The approach to supporting Oxfordshire place-based partnership
An initial conversation with Dan Leveson, place director for Oxfordshire, enabled the scope and approach to be developed for the direct support and the identification of the peers to undertake the work, ensuring the right timing and approach. 1:1 peer conversations played an important part in collating all views about what was working well and what could be improved. This informed the focus for the subsequent facilitated workshops involving all partners at place.
Dan said: “The approach included one-to-one time with provider chief executives, chief executives of our local authorities, voluntary sector leaders and GPs; everyone really and these really in-depth interviews gave us such important insights.”
The impact
Dan said: “Working with the LIPS programme helped us to find ways to work outside of our normal organisational boundaries and to focus on relationships and partnerships, rather than just working within existing structures. We had some really challenging conversations and having people from outside the system, with that independence, really helped.”
The integrated care board (ICB), through the place directors and establishing place partnerships, will ensure that authority and formal delegation (if required) for ICB functions supports delivery. The ICB is only one of the partners in place and for these partnerships to thrive, all partners need to consider what they can do better together, what change they could already make, and what authority they need to cede to the partnership to make joint decisions to deliver improved outcomes for their residents.
A comprehensive paper on place development was presented to the ICB board with input from partners.
All the place-based partnerships now meet in a clear structure and systematic manner and can articulate local priorities and programmes that are important locally and align with the integrated care partnership strategy and joint forward plan.
Berkshire West ‘the place of places’ has held specific workshops to identify and understand how to build a common programme to ensure they identify work programmes that operate at neighbourhood, local authority and place partnership level.
In Buckinghamshire three priorities have been identified: transforming special educational needs and disability (SEND); joining up care and tackling health inequalities; and a forward plan for the partnership will ensure that these priorities are tracked and reviewed alongside key enablers like workforce.
In Oxfordshire plans are focusing on the following four service areas: children and young people; working-age adults mental health and wellbeing including learning disabilities and neurodiversity; people with urgent care needs; health inequalities and prevention.
Each Place Partnership is also engaging in ongoing leadership development work.
The outcomes
Strengthened relationships have enabled conversations about the shared priorities with areas of focus agreed. This has enabled more structured meetings and co-developed new programmes of work to ensure implementation of the priorities.
The system has moved forward significantly since the peer support programme took place, in developing trusting and collaborative relationships between local authority and NHS providers but also at primary and secondary care.
Dan said: “Since the programme we have continued to meet monthly and have now got a maturity matrix in place and are demonstrating a lot of progress, particularly within our community-based work and our work around inequalities and urgent care. We have been able to take decisions as a place-based partnership that were not possible 12 months ago, so taking part in this peer process has made a real difference.”
