Client: London Borough of Barking and Dagenham
Date: August 2019 – February 2020
Challenges faced by the client: The London Borough of Barking and Dagenham’s (LBBD) all-age disability service faced a significant projected increase in demand while budgets remain constrained. LBBD also faced specific local challenges. The borough is the 5th most deprived local authority in England and has one of the youngest populations in the country. This meant that transitions to adult services was a key area of focus.
Amidst this, the service remained committed to achieving good outcomes but recognised that to do so would require redesigning user pathways and adopting an alternative delivery model. To achieve this the service planned to transform the relationship it had with residents to embed practitioners in the community. Management felt this would support the service to adopt a more preventative way of working, addressing need in the community earlier.
Support offered: The MV team carried out an options appraisal to identify the preferred model for the service and developed a comprehensive Business Case for a new delivery model. We worked with staff across the service to identify key cohorts of people within the Borough who were harder to reach and at risk of poor outcomes. Through a collaborative process, we mapped the user journey for three cohorts of people with learning disabilities, identifying the key interactions and pain points along the pathway and practical opportunities for improvements. We developed a high-level prototype of the six most promising opportunities to support LBBD to evaluate whether these should be taken forward to implementation. This work is highly relevant to the Greater Lancashire plan requirement to quantify the cost and size of the vulnerable people cohort in Lancashire and the costs and benefits of sustainably reducing demand.
Our support included: developing a robust case for change; identifying innovative models for delivering all-age disability services and how these could operate locally; analysis of national and local data; financial modelling; identifying procurement and governance arrangements; analysis of the costs and benefits; pathway mapping; identifying evidence-based interventions based on pathway analysis and developing a robust implementation plan.
Outcome achieved: This project made important steps towards supporting LBBD's LD service. It developed a new service model and an outline of the ways of working which would be needed to improve outcomes for people with LD and protect the long term financial viability of the service. Council's across the country have struggled to implement a preventative approach for people with LD and elements of the approach could be scaled to other boroughs. LBBD decided that it was not ready to implement these plans until it has strengthened financial and operational controls within the service. We worked with LBBD to develop a governance system to review whether the service is ready to move towards a new delivery model, and worked up an implementation plan for how this might be achieved.