Local Area Coordination and reform
Whole-system change, not add-ons
Local Area Coordination doesn’t just build connections at the individual, family and community levels.
It also drives reform and systems change across all service types: making services more personal, local, flexible, accountable and efficient. It does this through:
- Becoming a single point of contact in the local community which increases community engagement and coordinates service responses – the “new Front End” of the service system,
- Building sustainable local, non-service solutions to support needs,
- Building a detailed picture of the the area’s assets, resources and potential,
- Developing community leadership, starting with community involvement in recruiting Local Area Coordinators.
It therefore provides the opportunity to think about services in the context of Local Area Coordination and asset based approaches to:
- Accessible, single, local point of contact,
- Intentionally simplifying the service system,
- Push formal services back a level,
- Map the current use and outcomes of existing services/professional roles within and across service types/silos (e.g. children and families, adult social care, health, mental health, older people, housing etc),
- Identify areas of high quality or duplication across service types,
- Think about the role and desired outcomes of formal services,
- Plan for the gradual transfer of resources from services to prevention and local communities (localism),
- Build partnerships and efficiencies with other service silos,
- Apply asset based thinking to commissioning and provider services,
- Expectations re outcomes, reducing dependency, evidence,
- Developing alternative, asset based approaches to community living increasing choice for local people.
Why do we need reform?
Unintended consequences of the system
Over many years, the health and social care system has become very complicated (for people/families) and has focused predominantly on services and money for solutions. This has resulted in significant unintended consequences including:
- Encouragement of public dependency on services and money,
- The professionalisation of day to day activities associated with caring for each other replacing relationship-based and freely given care/support with systematised and paid-for services,
- A culture of waiting/competing for funding and services, rather than developing local solutions and self sufficiency – People being fitted into services,
- Subsequent reductions in community capacity/resources,
- Increasing exclusion and isolation for people,
- Personal budgets giving eligible people control over funding, but limited choice of services/informal supports available,
- High and increasing costs,
- Rationing of funding increasing unmet need,
- Informal and community resources are often either unknown (to both commissioners and local communities), unused or under developed,
- A complex system multiple service silos (e.g. children & family, adult social care, health, mental health, older people etc) that often don’t connect, result in service gaps, duplication of resources, are centralised and excluding people,
- Pressure on finances resulting in cuts to already poor services, rather than transformation, prevention and capacity building
In the challenging economic climate, there is an increasing risk of services being cut meet budgetary requirements. The risk is that innovative services such as Local Area Coordination which can promote individual, family and community capacity, support non service responses to need and drive wider reform, accountability and efficiency in the social care system may also become vulnerable to short term savings.
Leadership is required to support and nurture Local Area Coordination, innovation and reform.
It is important for Local Area Coordination to be understood, supported and embedded in the community and system as a driver for short, medium and longer term reform.