To provide a presentation to the Panel on ‘locality working’, a community-based approach that aims to better address need in local neighbourhoods, reduce inequalities and build better outcomes with and for residents.
Minutes:
Charlotte Pomery, Assistant Director for Commissioning, introduced a presentation on Locality Working in North Tottenham, supported by a number of colleagues from partner agencies.
Background to Locality Working
Jonathan Gardner, Director of Strategy at Whittington Health, introduced the background section of the presentation, beginning with setting out what local partners were trying to achieve with residents. This vision had been defined as “We want to work alongside residents to prevent issues arising and nip them in the bud early, through more integrated public services and more resilient local communities.”
This vision required a simpler, more joined up system and integrated, multi-disciplinary teams tackling issues holistically by building relationships and looking at the root causes of problems such as debt or ill-health. This needed a workforce who feel connected to each other and able to work flexibly across organisations along with a partnership with the voluntary sector. The approach would be enabled by a person-centred approach to care and joined-up governance with a mature approach to finance across the local system.
Rachel Lissauer, Director of Integration at NCL CCG, said that the approach involved encouraging difference groups of people who work with residents and patients to feel that they are part of the same team and recognise when they are working with the same residents and patients. It was important to recognise that GP surgeries were often doing the care navigation for a patient and so the locality approach had been built around the geography that made sense to GPs. The shape of the three localities of west, central and east Haringey had therefore been drawn to fit around the existing Primary Care Networks (PCNs). This also enables the identification of issues and priorities in different areas of the borough. In the west this included a higher proportion of older people and a risk of social isolation, the central area has higher levels of disability and food insecurity and the east has the highest level of deprivation.
Charlotte Pomery explained that a successful “test and
learn” had been held in North Tottenham and would be used as
a blueprint to roll out the localities model across Haringey. This
was underpinned by being accessible and open to residents, being
located within communities, working with people as early as
possible and a commitment from the Borough Partnership to support
frontline staff to work differently.
The approach would be supported by a number of Community Locality Hubs which would provide physical spaces to enable locality-based working and an Integrated Locality Centre within each locality which would focus on the integration of health and care services. Connected Communities would be part of the model, providing a bridge between residents and statutory services when issues are identified.
Responses were then provided to questions from the Panel:
Connected Communities
Florence Guppy, Strategic Lead for Community Enablement, introduced this section of the presentation with a map illustrating the areas covered by the eight Local Area Coordinators (LACs) that were now working in the borough and the hubs that they were operating from where different services work together. Due to the current Covid restrictions, the only premises currently being used for this were Wood Green and Marcus Garvey Libraries, Hornsey Health Centre, Northumberland Park Resource Centre and Commerce Road Resident Centre. It was hoped that further locations would be opened up from April onwards.
The areas covered and the hub placements had been designed to broadly correlate with the West, Central and East localities, though residents were free to access any hub of their choice irrespective of where they lived in the borough.
The response to the Covid pandemic had led to engagement with residents over issues such as claiming Statutory Sick Pay, self-isolation payments or connecting people with loneliness or well-being support.
Connected Communities had run a proactive campaign in the summer to identify people eligible for Pension Credit but not claiming it. This had increased residents’ income by almost £90,000 a year overall. More proactive campaigns would be launched over the next year based on data and insight to identify areas where further support could be offered to residents and then measuring the impact and Social Return on Investment.
A case study was provided of a resident who had recently been
discharged from the North Middlesex Hospital following treatment
for Covid-19. While the regular follow up happened, such as an
occupational therapy assessment, some financial challenges that the
resident was experiencing were flagged to Connected Communities
which was able to assist with their rent arrears and an attendance
allowance claim. The resident was an army veteran and had also been
a miner and so Connected Communities referred them to the Royal
British Legion and a coal mining charity which had provided access
to some grants and also social activities.
Richard Gourlay, Director of Strategic Development at North Middlesex Hospital, reported that Connected Communities had been working in the A&E unit at the hospital for around 18 months. While pick up had been slow to begin with, the pandemic had provided an opportunity to review what was provided and they had gradually been linked to other services, including the paediatric team and the oncology team, to provide support to those individuals as well as their families and carers when there may be social care or other problems. Connected Communities was recognised as an important facet of moving forward, were part of the hospital’s Keeping Healthy Board and the aim was to increase the number of referrals.
Responses were then provided to questions from the Panel:
Localities working in practice and Leadership teams
Andrew Wright, Director of Planning & Partnerships at Barnet, Enfield and Haringey Mental Health Trust, presented slides on how the localities approach works in practice. He described localities as the unit where integration and the delivery of joined-up services comes together and can support residents more holistically instead of separately addressing different aspects of their lives in silos. At every level this was about building relationships, bringing down boundaries and joint problem solving.
Chris Atherton, Principal Social Worker, spoke about the three Locality Leadership Teams which had been set up to ensure that the strategic vision of localities could be operationalised. The focus of the initial meetings was on the identification of appropriate estates from which to operate the hubs and also on the mobilisation of the workforce within communities. A decision had been made to merge the three leadership teams into one team in order to avoid things becoming disjointed and to ensure alignment and coordination during implementation. The team had an ambition aim to open a physical hub in each locality by August 2021.
Haringey was using a strengths-based working approach in its work with people across the borough called Head, Hands, Heart to focus on the strengths that people have rather than focusing on the problems and limitations that they have. A Champions Programme had been developed to promote the work across the borough. ‘Champions’ had been identified across the borough partnership including from the Locality Leadership Team.
Rachel Lissauer said that, in terms of the estate development in the east of the borough, Lordship Lane was being worked towards as the main Integrated Locality Centre but, as they were conscious about the need for good access and transport links, a multi-site model was also being considered. Sites could include the Northumberland Park Resource Centre, the Selby Centre and Broadwater Farm which already has a GP surgery on-site.
Responses were then provided to questions from the Panel:
Working in North Tottenham
Charlotte Pomery presented some details about the locality approach in North Tottenham where the Locality Hub was based at the Northumberland Park Neighbourhood Resource Centre. The Centre was a large building with office space for hire that had previously been occupied by various local services but was currently underutilised so there was potential for the space to be used to bring local partners together. The hub would have three primary functions:
Geoffrey Ocen, Chief Executive of the Bridge Renewal Trust, set out the background to this, noting that the need for multi-agency centres had been identified a couple of years previously. Hassan Bala, a senior practitioner within the Tottenham strength-based team, explained how the six practitioners in the team worked with residents with a focus on what outcomes people want to achieve and enabling them to find the best solution drawing on their own strengths and the community resources. The assets in the local community had been mapped, enabling people to access resources through one place and help to build more independent lives. Juliet Chard, a community connector with Reach and Connect, explained that she and a colleague had been attending the hub since it opened last December. The benefits of this had included being able to build relationships with other partner organisations in a quicker way, on a regular consistent basis, space to develop ideas and solve problems together and better engagement with residents.
Responses were then provided to questions from the Panel:
Cllr Connor thanked officers and external partners for their presentations and all the information that had been provided and suggested that the Panel consider this and the additional information requested in order to provide comments and feedback in due course.
Supporting documents: