23.06.16
Bigger is not always best when it comes to devolution, says Locality
Tony Armstrong, chief executive of Locality, welcomes Sir Howard Bernstein’s pitch for place-based planning across Greater Manchester through a single commissioning hub – but argues neighbourhoods must remain the top priority.
It’s encouraging to see Sir Howard Bernstein – the ‘architect of DevoManc’ and chief executive of Manchester City Council – prioritising a place-based approach to public service commissioning.
An integrated commissioning hub, like the one mooted for Greater Manchester in his speech at the NHS Confederation annual conference last week, is a step in the right direction for addressing people’s needs, breaking down silos and committing to a programme of early intervention.
But there is a danger that, although creating a single centre for commissioning all public services should result in more joined-up holistic services, a mega, centralised operation could lose sight of what’s needed at a neighbourhood level.
Place-based commissioning is great – but not if that place is too geographically large and its residents have very disparate needs. In Greater Manchester, for example, people in leafy parts of Trafford will need different things to those living in more disadvantaged neighbourhoods in Manchester.
Sir Howard’s locality plans for each of Manchester’s 10 metropolitan areas will go some way towards ensuring real priorities are focused on, but essential to realising his vision will be commissioners procuring services from community anchor organisations, like Locality members, which deliver solutions tailored for their neighbourhoods and underpin a place based approach.
Locality’s network of 600 community-led organisations are anchors in their local neighbourhoods, steadfastly serving local people’s needs, looking at the whole person or family and understanding the links between employment, health, housing, family support and more.
Don’t exclude smaller local providers
To create a truly place-based approach, public service contracts must demonstrate social value, have a commitment to building community capacity, have a maximum value so as not to exclude smaller, local providers, and be driven by local people through co-design.
Our work with our members and with pioneering local authorities shows us that it can be done. Community-focused services commissioned and delivered at a local level give people what they actually need, when they need it – and this is particularly evident in the field of health and social care.
Locality member Barca Leeds is seeing huge success in a social prescribing project it leads with funding from West Leeds Clinical Commissioning Group. It is also collaborating with nine community-rooted partner organisations across five locality areas in West Yorkshire in the WY-FI (West Yorkshire – Finding Independence) project designed to improve the lives and wellbeing of people with the most entrenched multiple and complex needs. The project, funded by the Big Lottery Fund, supports people who have previously been failed by public services with issues surrounding homelessness, drug or alcohol addiction, reoffending and mental ill-health and allows real people to input into how, where and what services should be delivered.
In Calderdale, Shropshire and Wigan Locality is working with the local authorities to pioneer a community-led and focused approach, putting the needs of the neighbourhoods first, and working with our members to deliver holistic, person-centred solutions which meet the needs of the people in the their communities.
A place-based approach is just the first rung of the ladder
Devolution offers an opportunity to reimagine our public services, as well as our economy and democracy. It has the potential to people the power to transform their public services and improve where they live.
Locality and NAVCA’s key devolution principles highlight a need for public services to be built around the needs of local people and communities. Locally-focused services and involving people in their design and delivery means that they are more responsive to local and individual need, can provide more cost-effective solutions and help to focus resources on early intervention.
Devolution deals need to reject the myth that bigger is best and embed the principles of local commissioning and delivery by developing and growing local models of service provision, supporting capacity building in the sector, and co-designing in commissioning.
What’s particularly encouraging in Manchester is Sir Howard’s commitment to accountability, to rolling a place-based approach out for all public services – not just health and social care – and to working across sectors.
It’s great to see that Manchester is taking its first steps towards this approach, but this is just the first rung of the ladder. A clear plan is needed for engaging community-led organisations and service users and for commissioning under flexible contracts to reflect the changing needs of communities if it is to be successful, both in Manchester and beyond.