Market Engagement event:Combatting loneliness and social isolation in NorfolkWednesday 22 November 2017

2pm

West Costessey Hall, Queens Hill, Norwich, NR8 5BP

Purpose of the event

• Inform providers and stakeholders of the potential opportunities

available through this funding.

• Gather views from potential providers and stakeholders on how the

different service elements required to tackle loneliness in Norfolk,

could be delivered

• Providers and stakeholders to inform how we take this forward

• Inform potential providers of next steps and timescales

Agenda

• Background and context of this funding

• Outcomes and service elements

• How this fits with social prescribing initiatives and locality models

• Table discussions

• Next steps and timescales

• Potential procurement process

Aim of this funding

To provide loneliness and social isolation interventions that prevent, reduce or delay the demand for social care, health or other public services

Why loneliness and social isolation?

• The impact on physical health, mental health, and independence is significant

• It affects anyone at any age

• In Norfolk• 38,000 lonely people in Norfolk aged 65+, with more isolated

caused by physical or mental health problems at any age.

• Loneliness is biggest driver of demand into social care in Norfolk

Why loneliness and social isolation?

Growing recognition nationally: • Jo Cox Commission on Loneliness

• Campaign to End Loneliness

• Age UK Loneliness heat map

…and locally: • Combating loneliness and isolation a key objectives in the Norfolk’s

Older People’s Strategic Partnership Strategy

• Norfolk County Council’s In Good Company campaign

• Adult Social Care’s Promoting Independence Strategy

How we got to this point

• Oct ’16: As part of proposals to make changes to Housing Related Support services, Adult Social Care commit to spend £1.3m on a community based preventative interventions for people on the edge of needing formal care services and people on the edge of homelessness

• Nov ’16 – Mar 17: Proposals go to Public consultation and through Committee process and Full Council budget meeting – proposals agreed

• Mar ‘17 onwards: • Guiding principles developed and high level outcomes defined• Engagement work with stakeholders and service users to develop the community

support model priorities• Priorities identified as loneliness / social isolation, and homelessness (not part of this

process)• Loneliness models have started to be developed in localities, aligned to the Social

Prescribing initiative

Outcomes

• The high-level outcomes of this investment are to:

• Promote, maintain or increase individual independence• Create and increase individual resilience• Build individual confidence to avoid crisis• Understand and achieve what matters most to the person

Value of the loneliness investment

• £800k per year initially for 3 years

• Allocated across the 5 CCG areas for the prevention and reduction of loneliness and social isolation

• Funding allocated using loneliness risk factors

Funding distribution based on Clinical Commissioning Group boundaries

Aged 75 and

over

% of Norfolk

Population

People who

provide 20+

hours unpaid

care a week

General &

Long-term

Health

Problems

Marital Status

(Single or

Widowed)

Household is

Deprived in 2

or more

dimensions

Total Unit

Share

Weighting 10.0% 10.0% 30.0% 30.0% 20.0% 100.0%

Value £80,000.00 £80,000.00 £240,000.00 £240,000.0 £160,000.00 £800,000.00

Great

Yarmouth £15,048.63 £19,291.67 £57,125.30 £50,478.64 £40,895.17 £182,839.42 22.9%

North

Norfolk £19,276.93 £15,444.02 £47,228.33 £42,321.43 £27,954.46 £152,225.16 19.0%

Norwich £12,934.48 £13,003.48 £43,986.55 £59,627.73 £30,442.09 £159,994.33 20.0%

South

Norfolk £15,415.67 £14,071.21 £40,712.98 £43,207.94 £27,188.06 £140,595.87 17.6%

West

Norfolk £17,324.28 £18,189.62 £50,946.84 £44,364.26 £33,520.22 £164,345.23 20.5%

Service functions / elements

1. Proactively reaching the right people in need, understanding the needs and strengths of individuals, supporting individuals to meet needs (through interventions) and utilise their strengths

2. Enabling communities to provide own solutions to reducing loneliness

3. Enabling the provision of interventions to people experiencing loneliness

Service elements 1. Foundation

• Proactively reaching the right people in need

• Understanding the needs and strengths of individuals

• Supporting individuals to meet needs (through interventions) and utilise their strengths

Service elements2. Enabling communities

• Enabling communities to develop their own solutions to reducing loneliness through:• Targeted neighbourhood approaches

• Asset Based Community Development

• Volunteering opportunities (recipients and participants of)

Service elements3. Direct interventions

• Enabling the provision of interventions that directly support individuals to: • Maintain existing relationships (eg, transport and technology)

• Make new connections (eg, through group-based or 1:1 approaches)

• Change thinking / behaviours (eg. Build confidence, motivation)

Key requirements (1)

• Support is based on need, not on client group, age etc

• Interventions are:• Outcome-based

• Preventative and focused on maintaining the person’s independence

• Strength / asset-based (eg using ‘three conversations’ approach)

• Evidence-based (How do you know that the intervention will make the right difference?)

• Reduce demand for social care interventions and packages and/or demand for other statutory services

Key requirements (2)

• Service delivery solutions are coproduced with people with lived experience

• Delivery models enable open, fair and transparent opportunities for a broad range of organisations, providers and voluntary and community groups to deliver interventions

• Strategies are in place to recognise and mitigate against the impact of additional demand on the voluntary and community sector to deliver interventions

• Effective partnership working and collaboration, that makes best use of existing assets in the community, eg links with existing advice services, community hubs, district council services and social prescribing initiatives

Any questions?

Social Prescribing and Community Navigation

Rob Cooper

Head of Integrated Commissioning South

What is social prescribing? The King’s Fund says:• Social prescribing, sometimes referred to as community referral, is a

means of enabling GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services.

• Recognising that people’s health is determined primarily by a range of social, economic and environmental factors, social prescribing seeks to address people’s needs in a holistic way. It also aims to support individuals to take greater control of their own health.

• Those who could benefit from social prescribing schemes include people with mild or long-term mental health problems, vulnerable groups, people who are socially isolated, and those who frequently attend either primary or secondary health care.

The King’s Fund also says:

• There are many different models for social prescribing, but most involve a link worker or navigator who works with people to access local sources of support.

• Social prescribing schemes can involve a variety of activities which are typically provided by voluntary and community sector organisations. Examples include volunteering, arts activities, group learning, gardening, befriending, cookery, healthy eating advice and a range of sports.

• There is emerging evidence that social prescribing can lead to a range of positive health and well-being outcomes.

• However, robust and systematic evidence on the effectiveness of social prescribing is very limited.

Value of Investment in Social Prescribing• 2 years funding for social prescribing from the iBCF and Public

Health – total £950k per year.

• The funding from Adult Social Care and Public Health is available on a locality basis for up to 2 years from the point at which a delivery model has been agreed for each locality. Around £100k will be committed to spend on activities which support the whole model.

Value of Investment in Social PrescribingThe maximum amounts available per year for each locality are:

CCG

Over 19

resident

population

Over 19 weighted

Population

% resident

population

% weighted

population

£850,000 –

Total

NHS Great Yarmouth &

Waveney CCG 76,517 97,862 11% 14%

£119,000

NHS North Norfolk CCG 137,651 119,691 20% 17% £144,500

NHS Norwich CCG 156,006 166,291 22% 24% £204,000

NHS South Norfolk CCG 189,067 160,482 27% 23% £195,500

NHS West Norfolk CCG 137,506 152,422 20% 22% £187,000

STP excluding Waveney 696,747 696,747 100% 100%

Model for Norfolk• Referral pathways from social referrers to

community based wellbeing advisors/connectors • Link people to expert and specialist help to

resolve issues which negatively impact on their ability to stay healthy, manage their health conditions and live independently.

• Help identify appropriate community assets and connect people with communities

• An agreed consistent core approach, with local delivery and flexibility

Key principles

• Delivered at scale, accessible to patients from all GP practices across Norfolk

• Able to take referrals from Norfolk County Council

• Work with voluntary sector and district councils, acknowledging their expertise in this area

• One approach to evaluation built in from the start

• Asset based – utilise existing resources, including those from Local Authorities and existing community groups and voluntary sector

• Build on the existing learning and enthusiasm from current projects – LILY; South Norfolk

• Acceptable and trustworthy to clients/patients and referrers

Process – locality planning

Planning a delivery model for each locality

• District councils

• CCGs / primary care

• Social care operational teams

• Third sector representative organisations – Norfolk Community Advice Network; Community Action Norfolk

• Other stakeholders – providers, voluntary and community groups, libraries

• Local planning teams asked to consider how loneliness would fit into the delivery plans for social prescribing

• Work in Progress

Emerging locality social prescribing models

• All localities will enable access to link workers from NCC front door and other points of contact outside the locality

• Great Yarmouth – link workers attached to GP practices spending time with people referred to find out what matters to them and develop plans to achieve – referral on to formal services and less formal community activities. Linked into Council’s neighbourhood teams and hubs.

• West Norfolk (including part of Breckland)– Building and expanding the current LILY model to offer social prescribing and community support covering all ages and wider area – the FTE of 3 link workers will be provided through an expanded group of core organisations making best use of the specialisms and assets available.

• North Norfolk (including part of Broadland) – provide 3 FTE link workers aligned to the GP practices but not in them with referrals from GPs through Integrated Care Coordinators. Link workers offer short term focussed contact. Have level of competency in benefits and debt work.

Emerging social prescribing models continued

• Norwich (including part of Broadland) – 3-4 Living Well workers aligned to the Integrated Care Coordinators. Skilled in brief interventions, coaching and some level of social welfare advice.

• South Norfolk (including part of Breckland) – Building on the current community connectors model the 8+ connectors will be aligned to GP practices. Connecters provide social navigation, assessment and triage for people referred. In SNDC connectors are linked into and supported through the early help hub.

• Each delivery model is proposing to use community funds to support individuals and the development community activities/capacity .

What is required as part of the locality models to address social isolation and loneliness

Requirements will vary between localities –providers to work with localities to fully develop the detailed interventions:

Community support

• Wellbeing connectors to reach out and support people who are isolated and lonely using a range of interventions to enable people to build capacity through recognising and building on their strengths to meet needs.

• Providing service users with opportunities to access areas such as social groups, arts and creativity groups, physical activity sessions, learning new skills opportunities and local volunteering opportunities.

• This may include offering first step support such as accompanying people who are anxious to groups and activities

• Outreach support, attending and organising community events

What is required as part of the locality models to address social isolation and loneliness -2• Specialist knowledge and support – for example to support people with mental

health problems, people who are relatively marginalised from mainstream services, young people, people with learning disabilities/autism

• Key posts collocated in community hubs – close connections with link workers

Community capacity and development

• Community development workers and connectors or enablers (particularly in rural areas) to work with groups of people in their communities to support the creation of new activities and groups

• Develop peer support models using co-production to incorporate lived experience to support capacity and to develop approaches which are incorporated into local communities

• Community development roles using asset based approaches (such as ABCD)

What is required as part of the locality models to address social isolation and loneliness -3• Transport in rural areas – dedicated access to transport

• Coordination within a locality of community services, support services and assets

• Increasing capacity and scope of community activities

• Linking with and further developing volunteering and befriending opportunities

Questions and discussion?

Discussion 1 – case studies

1. What could be effective ways of proactively reachingthese people?

2. How do you think these people could be supported in their own communities to develop their own solutions to loneliness?

3. What specific type of interventions could support these people to make new connections, maintain existing relationships or change behaviours and thinking?

Feedback

Discussion 2 - locality models

1. How could providers best work with district councils and others in a locality to ensure these inputs?

2. What would the key opportunities and challenges be?

Feedback

Next steps

• We will collate your feedback from the discussions - if you have further comments or questions please contact us by end of Friday

• We will issue copies of the slides along with any questions and answers from today on INTEND and via email.

• If you are a provider and interested in being kept informed about any possible procurement process for this service, do please register on INTEND.

TimescalesMilestone Start End

Market Engagement event 22-Nov-17

Collate feedback from event - NCC

Commissioning & Procurement

recommendations on sourcing approach

23-Nov-17 29-Nov-17

Internal NCC management decision on

sourcing approach

06-Dec-17 06-Dec-17

Sourcing process 07-Dec-17 31-Mar-18

Services commence (first phase) 01-Apr-18

Any questions?

Procurement

ConsiderationsJoan Murray

Head of Sourcing

Light Touch Regime Framework

Agreements Framework Agreements:

are umbrella agreements under which the Council can award

contracts for goods and services

are fully compliant with procurement legislation

The Light Touch Regime (a feature of procurement legislation) applies

to social care contracts and allows the Council more flexibly in how

legislation is applies

Flexibility used:

Framework Agreements awarded for longer than 4 years

Allowing the arrangements to be re-opened to new providers if

more capacity is needed

How do I apply to be on the Framework

Agreement?

You need to register on In-tend (the Councils e-tendering system)

https://in-tendhost.co.uk/norfolkcc

You then need to express an interest in project NCCT41483

This will give you access to all the documents including the application forms

You can ask as many clarifications as you like through In-tend correspondence

We will answer all question via the clarification section

You need to send your application in by the closing date via the response section

You can submit the response as many times as you like, but we will only look at the last one

If you register now, you will automatically be told when the documents are available

Procurement TimelinesActivity Dates

Place OJEU Contract Notice 7/12/17

Tender return date 11/1/18

Evaluate tenders and award decision made 11/1/18 – 25/1/18

Intention to award letters 26/1/18

Standstill ends 5/2/18

Award Framework Agreements 6/2/18

Process to award individual contracts and

mobilisation

6/2/18 – 31/3/18

Services commence (first phase) 1/4/18

Application Form (AKA Tender)

You will need to confirm that:

You meet our minimum standards

You are financially sound

You meet our Health & Safety requirements

You will need to provide evidence that you can deliver services which

can make a difference (i.e. your trackrecord)

You will need to indicate & describe:

What your service offering is (innovative ideas are welcome)

Where you can deliver it

How much money you need to provide the service taking into

account the budget limitations

Calling off from the Framework

Agreement

We will consider the service offerings for each locality and decide (through applying criteria) how the budget should be spent to deliver the best outcomes

The funding has been allocated to each locality using a number of loneliness risk factors, but the services can be different as it will depend on the demographics of the locality and the local need

Contracts can be of a varying lengths as some activities will be short term (i.e. implementing a change) and other activities will be on-going

Contracts are likely to have allowable extensions (so that we can extend contracts that are delivered good results

A key element of each contract will be the requirement to deliver evidence that the services are making a difference (i.e. good quality but not excessive MI)

Our Commitment to you

The timetable is tight, but we will ensure that the application process is not too onerous

We will keep the questions to a minimum

If you need help then contact the procurement team and they will guide you through the process at sourcingteam@norfolk.gov.uk

Don’t be afraid to ask questions

Any comments on this approach? What are the positives and what are the negatives?

Any questions?

Contact details

Loneliness / social isolation queries:Jo Clapham – Commissioning ManagerEmail: jo.Clapham@norfolk.gov.ukTel: 01603 224061

Procurement queries: Joan Murray – Head of SourcingEmail: joan.murray@norfolk.gov.ukTel: 01603 222044

Thank you for your time