On the 13th and 14th November, the Local Area Coordination Network welcomed Eddie Bartnik to Derby to lead two national workshops, one for Local Area Coordinators and their line managers and the other for leaders in areas that are currently delivering, developing or in active discussions about Local Area Coordination. Our thanks to Derby City Council for hosting the two events and also to Thurrock Council and Inclusion North for their support.
Eddie is currently the Mental Health Commissioner for Western Australia and leading mental health reform throughout the state. He was previously Director General for Communities and had a long career in a senior leadership position in Disability Services where he led the development of Local Area Coordination. This innovative development led to wide scale, positive reform of services in Western Australia. After 25 years, Local Area Coordination is going from strength to strength, now driving national reform across all states as part of the new Disability Insurance scheme
In 2009, Samantha Clark (Inclusion North) and Paul Davies (VPST) supported me to bring Eddie to the UK for a series of Local Area Coordination workshops in England. This proved to be the start of the development of LAC in England and Wales, with inspirational leadership from Ruth Hicks (Middlesbrough) leading to the development of the first, highly successful, LAC site in Middlesbrough.
Move forward to 2013, we now have Local Area Coordination operating or developing in Derby, Thurrock, Monmouthshire, Walsall, Cumbria, Gloucestershire, Derbyshire, with new conversations emerging across England and Wales.
Local Area Coordination workshops—Derby.
On the 14th November, leaders from across England who are either delivering, developing or in real conversations about Local Area Coordination met to participate in a conversation about getting started, doing it right , reforming services and expanding with integrity for long term success.
Over the next few pages, we reflect on the rich conversations that developed at the event and highlight some of the emerging key themes.
Starting from the Start—Building Hope and Optimism
Too often, services start with questions (assessments) about need, deficits and problems. This often results in negative service labelling of individuals, families and communities, low expectations and service dependence.
Rather than “fitting” people into existing supports and services, it’s about walking alongside the person to build a positive vision, relationships, contribution, choice/control, personal resources and local solutions, plus access to relevant, timely and accessible information and services if needed.
Do we wait for crises and fix with services—or build resilience and help people stay strong?
Local Area Coordination starts at a difference place—it
- Takes time to get to know individuals, families and communities well over time—LACs are embedded in their local community, a community resource and partner
- Stands alongside people as they build and pursue their vision for a good life
- Focuses on gifts, resources, possibilities and Staying Strong—Hope, Optimism and Action instead of needs, deficits and queuing for services to “fix” problems
- Becomes the new “front end” of the service system, pushing formal services back a level as a complementary support to local solutions
If you start with the need and service questions, there are very limited options. However, if you take time to get to know people and help them build their personal vision for the future, possibilities are suddenly much greater.
The Choice—A focus on scarcity and rationing vs a focus on abundance, local resources and staying strong?
A Good Life
Everyone is different and therefore we all will have a different personal vision for a “good life”. But for most people, there are key themes around the importance of
- Valued, supportive relationships
- Choice, control and contribution
- Health, safety and security—Confidence in the Future
- A home of my own
Whilst services may be positive for some people, for many others they are less effective and can be an obstacle to inclusion and contribution.
There are some things that services can’t do—they can’t provide love, friendship, valued and mutually supportive relationships. These keep us strong and connected.
Services can’t solve loneliness and isolation—relationships do
What Does a Local Area Coordinator do?
The key to Local Area Coordination is the very intentional combination of connected roles, delivered locally alongside local people in their community. They become a single, local, accessible point of contact in the local community—the new “front end”
It combines a range of roles traditionally delivered by multiple services and delivers it very locally alongside local people and communities—it includes
- Taking time to get to know people, their families and communities well
- Providing accurate, timely and accessible information in a variety of ways, including by supporting development of supportive relationships with people with “lived experiences” (experts by experience).
- Supporting people to build valued, supported personal relationships and connections
- Supporting people to identify, use and share their gifts, strengths and experiences (contribution)
- Building more welcoming, inclusive and mutually supportive communities
- Supporting people to self advocate—to be heard, have a voice
- Supporting people to control supports, services and resources—increase choice and control
- Building partnerships at the individual, family, community and systems levels
- Supporting people to stay strong—building local, flexible, practical solutions
- Support people to access and navigate services, where this may be needed
Fundamentals for Keeping Local Area Coordination Strong
The vision starts with the right question (person by person) —”what is you vision for a good life, rather than what services do you need?”
Local Area Coordination is underpinned by 10 Key Principles around the power and importance of relationships, information, control, choice, leadership, self advocacy and services as a necessary, but complementary, “back up”.
These principles both shape LAC practice, outcomes and wider service reform—central to success and outcomes for individuals, families, communities and services.
For more information about the 10 Principles, go to
Evidence and Outcomes
Local Area Coordination has been heavily evaluated over the past 25 years, across Australian states (over 20 evaluations/studies in Western Australia alone and is now driving national service reform), Scotland, and new studies in England. For a reading list of papers and studies, go to http://inclusiveneighbourhoods.co.uk/how-do-we-know-it-works/
What is clear is that “where it is designed with integrity and there is strong leadership across service types AND with communities the range of outcomes are highly consistent and predictable”. These include
- People supported to find and use local, sustainable, non service, no cost/low cost solutions—resilience and reduced demand.
- Increased supportive personal relationships and connections—reduced isolation.
- Better resourced and more inclusive and welcoming communities.
- Improved access to information—choice and control.
- Bringing new resources through partnership working
- Preventing out of area placements
- Families and carers more able to continue in caring role
- Improved access to specialist services
- Service reform— LAC as new “front end”, simplified. more connected services
Service integration is no use if not also connected with communities and citizens!
LAC—closing the gap between Citizens and Services/Decision Makers
What Have We Learned?
Where designed effectively, with integrity and with strong connected leadership, outcomes are highly consistent and predictable (see above).
The Local Area Coordination Network and Inclusive Neighbourhoods are leading the development of strong, locally relevant LAC programmes paying attention to.
–Establishing and embedding 10 Core Principles
–Clear LAC Framework underpinning best practice
–All ages & service types – 50-65 individuals/families
–A long term relationship – relationship is central
–Single, accessible point of contact in community
–Front end of service system – structural reform
–Reform Services as complementary back up, not front end
–Embed in system – Embed in community (citizen led)
– Full community involvement and contribution—co design
–LACs from a range of backgrounds—no single service/profession bias
–NO SHORT CUTS, no “pick n mix” or “hybrids”. Avoid “Pilots” – Commit to local communities, local solutions and reform
Local Area Coordination and reform requires conversations, partnerships, reflective practice and leadership. It’s not about to just grabbing a job description from somewhere else and say “we’re doing LAC”, or just turning existing roles into Local Area Coordinators—that undermines core principles around design and inclusion.
Local Area Coordination is about turning the system upside down, integrating/simplifying services (co-design with citizens and communities) and moving emphasis and resources from crises, assessment and services to prevention, capacity building, resilience and local solutions.
In emerging sites, it’s not only delivering outcomes consistent with best practice evaluations, but also driving cultural change across other services. It is nurturing a strength based focus and action across professional roles—that doesn’t mean other professions are “doing LAC”, but it is helping services to become more personal, local flexible and accountable.
It’s not a panacea for all social care and health challenges, but it is creating space and conversations about the future purpose and desired outcomes of services and the increasing role and contribution of local people and communities.