Client: Cornwall Council
Date: November 2017 – December 2018
Challenges faced by the client: In 2017 Cornwall Council had a ‘Good’ rated Children’s Service, following a successful improvement journey. However, the Council was seeing rising need from children and families, and reduced resources across the system in the context of increasing statutory duties and rising expectations. Looking ahead, this left the Council with a £6m budget gap just to ‘stand still.’ The wider system of NHS services for children were also under strain and overspending against their budgets.
The Council and its partners had a long-held aspiration to integrate services for children and families, and this was a key commitment in the Devolution Deal.
Closer integration of children’s education, health and social care was seen as the best way of meeting rising need and improving outcomes. However, there were significant challenges in bringing about integration as important responsibilities across typical pathways for vulnerable children and young people were held by different public services. Despite efforts, there was a widespread recognition that to date, the development of integrated approaches as a universal and early help level had been piecemeal.
In 2017 the Council carried out an options appraisal which identified an Alternative Delivery Model as the best way of integrating children’s education, health and social care services.
Support offered: Mutual Ventures was commissioned by the Council to develop a full business case for a highly innovative alternative delivery model to deliver integrated services for children and families across social care, education, public health, early years and early help.
We supported the Council to develop a robust and compelling business case which addressed the priorities and concerns of members, partner organisations, staff in children’s services and the corporate centre. This included making the case for the integration of some NHS delivered public health services into the council.
The MV team worked alongside Cornwall’s senior officers and staff across key support services (e.g. finance, legal, HR) using a collaborative approach. Our work involved significant stakeholder engagement with elected members, officers and partners.
Our support included: integrated service design, strategic advice on engagement with elected members and the NHS to build the case for an integrated model; designing the structure of the new service based on our extensive experience and understanding of the Cornwall context; identifying governance arrangements – including to appreciate clinical governance; economic modelling of the benefits, costs and risks of integration; financial modelling and developing a robust plan for implementation. We supported senior officers to identify the best option for the local context and political priorities, including designing an alternative in-house model which could deliver full integration with a lesser degree of externalisation.
Outcome achieved: In 2018, Cornwall’s Cabinet decided to set up an integrated children’s services directorate with new system-wide governance. This achieved the benefits of full integration while retaining children’s services within the Council. The new Together for Families service went live on 1 April 2019.
Trevor Doughty, Director of Children’s Services, Cornwall Council said:
"Mutual Ventures (MV) worked seamlessly alongside our internal team, both on the development of the document and our approach to engaging with the key stakeholders. Engagement with elected members, staff and partners was critical to the success of this project and Mutual Ventures were instrumental in facilitating this.
The MV team established strong relationships with my senior team and staff across the Council, communicating clearly with everyone involved in the project. My senior team quickly came to view them as an extension of our own team who could constructively challenge and extend our thinking, support us to respond to events and find creative solutions to issues as they arose. MV combine high quality strategic thinking and expertise on new delivery models for public services, with a genuine empathy, honesty and commitment to improving outcomes for vulnerable service users. I would have no hesitation at all in recommending MV to colleagues who are looking for strategic and practical support to design and deliver change."