Changing the system, not the child: the social outcomes partnerships debateSponsored
Tuesday, July 28, 2020
CYP Now joined forces with Bridges Outcomes Partnerships to discuss how social outcomes partnerships can improve the lives of vulnerable children and families – by enabling flexible delivery, closer collaboration and shared accountability.
There are now more than 78,000 children in care in England, a rise of almost 30 per cent on a decade ago. Moreover, the NSPCC has reported a record number of calls to Childline between this April and June, raising concerns about an increasing number of “hidden” children on the edge of care.
The profound social and economic fallout of the Covid-19 pandemic has only exacerbated the challenge of trying to improve the lives of these vulnerable children and families. The funding gap for local authorities has widened to £7.4bn, according to the Local Government Association, while UK charities, many of which work with these families, face a £10bn funding shortfall over the next six months, according to Pro Bono Economics.
In such a challenging funding environment, it is vital to ensure that existing budgets are spent as efficiently as possible – while still experimenting with new approaches that can help to improve public services over time.
CYP Now hosted a virtual debate on 15th July to discuss the potential of social outcomes contracts to address some of these challenges within children’s services, in conjunction with Bridges Outcomes Partnerships (BOP), a not-for-profit social enterprise launched by Bridges Fund Management.
BOP works with local authority commissioners and impact-driven delivery partners to co-design bespoke support programmes for vulnerable children and families in areas such as mental health support, family support and therapy, working with vulnerable women, and coaching young people leaving care to help them achieve fulfilling lives and careers.
The government commits to paying for pre-agreed milestones achieved by these projects – for example, improvement in emotional and mental wellbeing, or progress at school – as opposed to specific inputs (such as a certain number of staff), as is usually the case with traditional contracts.
BOP also provides the project finance required to deliver these programmes, from funds backed by a group of socially-motivated organisations including The Office for Civil Society, Big Society Capital, The Esmée Fairbairn Foundation, Trust for London, Guy’s and St Thomas’ Charity, Pilotlight and Project Snowball.
Since 2012, BOP has supported 50 social outcomes contracts across the UK, working with more than 24,000 beneficiaries through 98 charities and social enterprises, in partnership with 65 commissioners in local and central government.
All these projects share three key features: flexible delivery models (which use data to create continuous improvement); a collaborative partnership approach; and clear, shared accountability for improving lives.
The aim is to make it easier for multiple commissioners, funders and delivery partners to work together towards a shared set of outcomes.
West London Zone (WLZ), which is supported by Bridges, is a charity that works intensively with vulnerable schoolchildren. Chief executive Louisa Mitchell lauded the flexibility WLZ has under the contract to adjust its service to suit the needs of a particular child or family.
“The children we want to help are those with multiple interrelated needs – deprivation, low levels of parental engagement, low wellbeing, poor attendance at school and low grades,” Mitchell said. “There’s no one silver bullet that’s going to solve those. If you’re going to work with children with multiple complex needs, they all need a personalised programme to address their particular risk profile and deliver those outcomes.”
The key is to have contracts based on a set of delivery milestones rather than an exact service specification, she explained. “This enables you to design a service that really works for individuals. It also allows you to devolve decision-making to the frontline teams, who know the families and children really well, and know what will work for them.”
Since WLZ’s link workers know these families so well, they recognised quickly in the wake of the Covid-19 pandemic that some of them needed additional support over and above the usual WLZ service – so they raised an additional £35,000 of philanthropic money to buy food and household essentials, IT and creative resources for home learning, and even extra language support.
Other service leaders in the debate agreed that having a contract based on flexible milestones rather than a predetermined service enables a more relationship-focused approach.
Reboot West and iAspire work with care leavers in the west of England and south-east London respectively. While the programmes received the same funding, with a similar structure, the actual service is slightly different due to the different locations and backgrounds of the care leavers supported. “The young people in the different regions have slightly different challenges and complexities,” said Iciar Ania, investment manager at BOP, who works on the programmes. “It has been really interesting to see how the two delivery partners – 1625 Independent People in Bristol and Depaul in London – have been pursuing the same goal, but with the flexibility to change how they reach that goal.”
Robbie Smyth is director of Forward, a BOP-supported programme that supports Trevi House in Plymouth to work with vulnerable women who have had multiple children taken into care (there are 24 women currently on the programme, and collectively they have had 78 children taken into care).
Smyth explained that Forward’s intervention, Pause, involves working intensively with these women for 18 months. While a lot of work went into easing the transition for those completing the programme, the women felt they would benefit from more structured long-term support. So, Forward used the flexibility of the contract to free up funding for a second layer of care to support those women for a further 18 months.
“We’ve been able to release some budget to bring in a dedicated role that will pick up the women at that 18-month point and provide support for an additional 18 months. That’s something we’ve only been able to do because of the social outcomes partnership and the flexible financing it offers.”
This kind of additional investment has traditionally been very difficult to find.
Anne Marie Carrie is chair of BOP’s children services arm, and a former chief executive of Barnardo’s and ex-local authority children’s services director. She said leaders often consider it “counterintuitive” to invest in services that appear to be flagging; that if the desired results are not being achieved, the “obvious thing to do seems to be to cut funding”.
BOP will sometimes take a different view, she said. “What people often do is just cut back resource – rather than saying: ‘If that’s the problem, what’s the answer?’ For us, that might mean drawing down extra working capital to fund additional resource.”
She added that the other big benefit of these contracts is that they provide charities with secure, long-term funding – which is particularly important in the current environment. “The small charities and social enterprises that are really close to the children, to the families, who really know what works, have been at the mercy of these 12- or 18-month contracts – so they can’t necessarily build up the quality of their staff or their intervention.”
Steve Walker – former director of children’s services at Leeds City Council, who now leads the council’s Strengthening Families, Protecting Children Improvement Programme – agreed that this long-term funding approach generally creates more scope for flexibility and innovation.
Walker said: “During my time [at Leeds], we reduced costs on looked-after children by £12m; and some of that money had to be used to maintain investment in early help and preventative services. Imagine what we could have done if we’d been able to keep all of that money as a guaranteed funding stream over three, five years?”
Collaboration is also at the heart of these contracts, including co-creation of services and co-ordination with other services (see box).
Becca Dove, head of early help at the London Borough of Camden, highlighted the importance of thinking about the ‘interdependence” of services, and what this means for commissioning and delivery. “In family work and in social work, if you press a lever over here, but somebody presses a lever over there, then your lever doesn’t work anymore.” Reflecting on a dispute over responsibility for a teenager she was working with a decade ago, she pointed to the widespread disconnect in some local authorities between different teams.
BOP currently supports a number of family therapy programmes. It works with Norfolk County Council and Suffolk County Council on a programme called Stronger Families, which is delivered by Family Psychology Mutual (FPM) using an intervention called Functional Family Therapy; while in London, it now works with 10 boroughs across the city on a similar programme called Positive Families Partnership (PFP).
In each case, the programme receives outcomes-based payments for every child kept out of care through the service.
Brigitte Squire, clinical programme director at PFP and FPM, explained that working with one local authority in Norfolk presents very different challenges to working across 10 London boroughs, so it takes careful collaboration with the commissioner to tailor the programme accordingly. For example, in London, PFP used the flexible funding of the partnership to add an extra service manager to support the therapists – having secured the buy-in of the boroughs.
Reflecting on the services delivered by FPM and Bridges, Vicky McCaig, programme manager of the Stronger Families programme, said collaborative working has “driven forward” the success of the project.
“The team is very much integrated within the local authority, even though they are not employed by them. The local authority staff see us as a team that is approachable and as a resource of people who are helpful just to have case discussions with. Even if a case doesn’t end up coming to us, I think they appreciate the expertise the therapists have, and being able to have those discussions.”
Emily Lown, commissioning and service development manager at Norfolk County Council, said: “We have a strong relationship with the Stronger Families and Bridges teams, meeting on a weekly basis to identify challenges and themes, and to monitor the number of children and families who have been referred or started the intervention. The relationship has allowed tweaks in our referral routes and processes, and within the project, we have been able to adapt this to bring better understanding and clarity, ensuring the right families are supported.”
Graham Beamish, head of programmes for children and young people at Suffolk County Council, which commissions the Functional Family Therapy Suffolk programme, agreed: “It doesn’t feel like a normal arm’s length arrangement you’d have with a third-party supplier. The team very much feel part of the council’s children services team. They’re co-located, so there’s very regular informal consultations about potential cases that are coming through. If we have an issue, we can work together to overcome it.”
This kind of collaborative problem-solving is one of the main benefits of partnership working.
For instance, BOP felt that if the Reboot West team was empowered to identify their own support and supervision needs, they would ultimately be able to achieve better outcomes for more young people (thus reducing the overall cost per outcome). Reboot was using an approach called “acceptance and commitment therapy”. BOP offered the team additional funding to support further training and clinical supervision in order to make them more effective.
Reboot chair David Royce said: “BOP came to us and said: ‘We would like your team to decide how best they would like to develop and enhance their skills – because we think over the coming two years, that will lead to an increase in the number of successful outcomes.’ In my 20 years in the charitable sector, it’s extremely rare that someone says: ‘Here’s some more money – you decide how you’re going to spend it’”.
The other key element of these projects is to make sure all the parties involved have clear accountability for improving the lives of vulnerable children and families. In BOP’s view, that means having clearly defined metrics, reporting transparently against them, and investing in high-quality shared learning (which, crucially, incorporates the voice of the participants themselves).
Royce said this clear accountability for performance has been crucial in enabling Reboot West and iAspire to run smoothly, despite each programme working with young people over four local authority areas.
“We have a group of professionals who are responsible for making things happen in a multi-authority dynamic. There is real value in having a delivery partner with a clear set of key milestones and a clear set of expected results, whose job it is to make that integration and that collaboration work.”
Beamish also believes that having a clear set of shared goals is a key strength of Suffolk County Council’s partnership with FPM and BOP. “It’s not like a standard ‘payment by results’ programme, where different parties might have different incentives. It’s three parties working together very collaboratively with a set of aligned incentives – which I think means that together we can bring our own skills to the piece to deliver a better result.”
Without this approach, it would have been difficult for the council to invest in a service like this in the current funding environment, he added.
Ongoing data collection and evaluation is critical to this process. Lisa Holmes, director at the University of Oxford’s Rees Centre, highlighted the need to change “the very traditional way of working” whereby data and evidence operate almost independently from the programme as an “evaluation machine”.
By contrast, these programmes maintain a close link between evidence and practice, she said, allowing for “child-centred evaluations” focused on longer-term outcomes.
“I have seen from conversations with colleagues at BOP that the flexibility and the close way of working between all involved has helped develop some of those positive relationships between practice and evidence generation.” This is critical to inform public service reform, she added. “If we are going to be able to evidence what practices, interventions and programmes work best for children and families, we need to have a shared understanding as to what works.”
Kate Tobin, Scotland director of Dartington Service Design Lab, said: “It’s about creating the conditions that allow people to learn. Looking at social outcomes partnerships from an evaluation perspective, there are two key questions. Do they support evidence-based decision making? And to what extent do they accelerate the diffusion of social innovation across the sector?”
She believes that if these models are “carefully considered”, they can become a “vehicle for decision-making grounded in evidence and can contribute to the direction of funds into quite effective practice.” This can benefit the sector more broadly, she added.
“It’s about getting that balance right between having that focus on clear lines of accountability, but also having a clear focus on learning that benefits not just the partnership, but those outside the partnership as well.”
CHANGING THE SYSTEM
Mila Lukic, co-founder of BOP, said that these projects were demonstrating the value of a more flexible, more collaborative and more accountable approach.
“We have seen that through this different way of working, we can actually deliver better results. Some of the partners we’ve supported have worked with 50 per cent more families than they would have worked with historically and are also achieving results that are 20 to 25 per cent better than they were delivering under traditional contracts. So we are seeing that it can change services – because it’s creating stronger relationships and moving away from a transactional or purely contract-based delivery. That has been really powerful.”
So can social outcomes partnerships contribute to the broader conversations about public service reform?
“The sector is rapidly evolving,” Tobin added. “It’s constantly learning about the kind of conditions that help or hinder social innovation, and experimentation, and evidence-based decision making.”
“What we want to achieve is to share these learnings as widely as we can so that they are picked up in various ways of delivery,” Lukic said. “It doesn’t really matter whether that’s a social outcomes partnership, or whether it’s a completely different model. What matters is that the learnings are out there, and they are being embedded in various ways of delivery.”
BOP children’s services chair Anne-Marie Carrie believes that in the current funding environment, local authorities need to be open to alternative models like these if they want to make their budgets go further.
“When I looked into [BOP] and the work they were trying to do in children’s services, I thought this could be an absolute game changer. For commissioners and procurement departments, this is just a complementary resource that assists elected members and officers to realise their ambitions in the context of shrinking budgets. What I believe we have is something that could contribute massively to public service reform and to innovation.”
- Ravi Chandiramani, Publisher, CYP Now
- Anne Marie Carrie, Chair, Bridges Outcomes Partnerships Children’s Services
- Mila Lukic, Co-founder and CEO, Bridges Outcomes Partnerships
- Tim Aldridge, Corporate Director of Children & Young People, London Borough of Newham
- Graham Beamish, Head of Programmes, Children and Young People’s Services, Suffolk County Council
- Becca Dove, Head of Early Help, London Borough of Camden
- James Gracey, Head of Service, Commissioning, Children’s Services, Derbyshire County Council
- Lisa Holmes, Director, Rees Centre, Oxford University Department of Education
- Emily Lown, Commissioning and Service Development Manager, Norfolk County Council
- Vicky McCaig, Stronger Families Programme Manager, Family Psychology Mutual
- Louisa Mitchell, Chief Executive, West London Zone
- Cristina Odone, Head of Family Policy Unit, Centre for Social Justice
- David Royce, Chair of Reboot West and iAspire
- Robbie Smyth, Director, Forward, Bridges Outcomes Partnerships
- Sharon Sober, Senior Policy Adviser, Children in Care and Permanence Team, Department for Education (not pictured)
- Brigitte Squire, Clinical Programme Director, Positive Families Partnership
- Kate Tobin, Scotland Director, Dartington Service Design Lab
- Steve Walker, former DCS and now Project Director, Strengthening Families Programme, Leeds City Council
- Iciar Ania, Investment Manager, Bridges Outcomes Partnerships
- Fiona Simpson, Online Editor, CYP Now
10 KEY ENABLING INGREDIENTS WHICH HAVE MADE A REAL DIFFERENCE
Flexible delivery and budgets that can be adjusted as we learn; collaborative partnerships across sectors and organisations; and more holistic accountability than traditional contracts
- Create more personalised services focused on improving people’s lives
- Enable delivery teams to continuously innovate and improve their service
- Invest more into professionals delivering the services
- Use data and technology to create efficiency and innovation continuously
- Co-create services with end-users, frontline staff and experts
- Develop and deliver the solution with the local community
- Co-ordinate with other services to create wider systems change
- Agree clearly defined metrics, and report transparently against them
- Ensure participants’ voices are properly heard when evaluating the service
- Invest in high quality learning, and share that learning widely
Source: Bridges Outcomes Partnerships, www.bridgesoutcomespartnerships.org