Discussion on prospective alignment of TLAP and C4CC

Summary of TLAP Partnership meeting – 29 November 2017. Martin Routledge, from In Control and TLAP Board member, explained the thinking behind the proposed alliance between C4CC and TLAP. 

This was summarised in the briefing note sent to partners on 27 November. Table discussions identified benefits and concerns as well as how a closer relationship might advance personalisation in the health and social care sectors. The proposal was broadly welcomed in discussion, as it had been at C4CC’s own partnership event the previous week.

Next steps

We will now start to develop a shared vision for the future and establish a task and finish group from both organisations to progress the work. The key themes that emerged in feedback are summarised below.

Potential benefits and TLAP’s strengths

  • Provides opportunities for a stronger/louder voice on personalisation – a single integrated voice enables a bigger impact
  • TLAP’s strength and expertise in co-production through NCAG
  • Creates a very broad partnership of citizens, commissioners and providers (multiplier effect)
  • Supports innovative thinking and models a closer integration between health and social care sectors
  • TLAPs reputation/independence and potential for greater reach
  • Enables a progressive, positive vision of what public services should be e.g. welfare reform, housing, communities, and wellbeing.

How can alignment promote personalisation?

  • Facilitates the development of a shared culture within health and social care and opportunity to develop a shared language to help collapse the artificial divide between health and social care
  • NHSE agenda is not currently driven by personalisation – a joined up organisation could help prioritise personalisation whilst strengthening the importance of social care, which is currently perceived as a ‘poor relation’
  • A stronger voice and more convincing message if it comes from an aligned position, and ability to influence policy to ensure people get a better life
  • Provides a stronger approach to co-production and potential at individual, local, regional and national levels.

Risks and concerns about aligning

  • Concern that one organisation tries to carry workload originally performed by two, with consequent risk of dilution, being spread too thinly to be effective – volume of work vs number of staff
  • Managing the expectations of funders and needing clear commitment from both funders to provide necessary stability
  • Making sure that relationships are maintained and developed within NHSE, that funding is secured quickly
  • Risk that bigger partnerships add complexity and difficulty reaching consensus
  • Bringing together 2 sets of staff/budgets/governance/co-production groups. Potential to get mired in the process detail and lose sight of our purpose
  • ​May distract both organisations from work plans and current objectives.

Green paper on social care

A selection of partners gave a two minute pitch on what they would hope to see in the forthcoming green paper. Table discussions amplified these hopes:

  1. People. We need sustainable funding for older people and those of working age, a recognition of older people’s contribution, and a clear vision for their role in society. We must have provision of support for carers, including carers who also personally access health and social care. We should look at the lifecycle of people, not singling out older people, and ensure the wellbeing principle is enshrined in the green paper.  
  2. Getting our voice heard. Nothing must be commissioned without the voice of   people who use services. We need to find some way of getting the voices of people who use services heard in its preparation (through the advisory board).3
  3. Funding. Funding should be sensible and sustainable. The artificial divide between health and social care, which has an impact on charging, must be eliminated. The access and availability of support which has a regional variation in quality and cost must also be stopped. We need to explore value for money of hospital places versus adult social care. UN Convention on human rights fully embedded within UK policy, reinforces current rights already outlined in existing legislation and policy e.g. make the Care Act work properly. Green paper needs to properly address funding requirements to enable this.4
  4. Innovation. Investment in innovation is crucial as we cannot continue to do more of the same. Innovation must be core theme to encourage permission to respond creatively.5
  5. Communities. We need a proactive society with ‘family friendly communities’ that supports all citizens to have a good life. We also need a ‘community spirit’ which rebalances the system so that the burden is not unfairly on carers. Investment in things like Local Area Coordination.

What can we do to make sure that a new partnership with C4CC engages with the green paper, both before and after it’s published?   

  • Contact members of the advisory group and challenge them on how they will ensure voice of co-production is included. Offer to run some co-designed sessions. Through the partners form an expert group e.g. Age UK, Care England. Invite Green Paper advisory group to a session run by TLAP/ C4CC. Make an offer to the cabinet office as convener of the sector.  
  • Partners to write an open letter to contribute our ideas to green paper.
  • Make use of Making It Real to feed into green paper - frame it as a positive contribution.
  • Find allies, need groundswell of support e.g. Rt Hon Norman Lamb MP, Paul Burstow - chair of SCIE.
  • Produce a TLAP branded ‘crimson paper’ in parallel with green paper; well-argued/ well evidenced, which would be a model of co-production.
  • Green paper should be a standing item on the TLAP Board agenda

TLAP’s priorities for 2018-19

Partners briefly discussed where they felt TLAP’s priorities should focus:

  1. Getting the alliance in place with C4CC 
  2. Build on priorities to put personalisation front and centre – and extend across the broader public sector in response to integration challenges, wellbeing and prevention (no integration without personalisation)
  3. Continue to extend reach and influence of personalisation into Sustainability and Transformation Partnerships (STPs) and Accountable Care Systems (ACSs)
  4. Strengthen the evidence base for personalisation
  5. Define the relationships with co-production groups; NCAG and C4CC. Develop the ‘co-production’ offer for NCAG to other organisations.