Making social care transformation real

Donna Hall, CBE, Chief Executive Wigan Council and Wigan Clinical Commissioning Group, shares how the Wigan Deal and cultural change has transformed social care in the borough.

donna-hall-375px.pngHow many transformation strategy documents and action plans have you written, read or contributed to? And how many of those expensively produced, consulted-on documents have made a significant and long-lasting impact on the people’s lives, the organisation or the place they’re meant to help?

Reflecting on the work we’ve done in Wigan, my advice would be to rip up all those wordy strategies that hardly anyone reads. They just don’t work. Focus on creating an energetic, innovative, trust-based model and spend years reinforcing it every day. This has to be the best way we can spend our time as leaders.

The Wigan Deal

The Wigan Deal is a single unifying philosophy that binds together every person who lives and works in the borough, combined with a massive cultural-change programme. It’s unique for being an all-encompassing, long-term, cost-driven, community-driven, whole-person, whole-place, multi-agency approach. The Deal is a child of austerity, created when a Financial Times journalist told us Wigan was the third worst affected council in the UK. We realised that slashing the same 10% off every departments’ budget wouldn't work on a long-term basis and we needed a clear and simple transformation plan that embraced both the council and the people of the borough. Eight years in, the results are astounding. We have low staff turnover in all areas, amazing staff engagement scores and are the third most productive council in the UK.

Changing the internal culture to harness motivation

Cultural change has been core to making the Deal work. For most people in public services – from bin loaders and planning application officers to housing benefits staff – there’s a personal passion to help people in their communities and to improve the place. We miss a trick if we ignore this primary motivation when we create management structures.

Eight years ago the council had an incomprehensible management architecture. The cost of this archaic, yet fiercely defended construction was astronomical. But personal accountability was the main issue. Where does the buck stop in seven layers of management for any one issue? Slimming down the structure and giving staff the freedom to innovate on the frontline creates a positive and productive culture. It releases energy, creativity and built-up frustration from previous poor management decisions.

Moving to a strength-based approach

We developed the ‘Be Wigan experience’, an interactive, immersive, half-day development programme for all staff and managers to explore how we can shape and reshape cultures in teams. This means we are all singing from the same cultural hymn sheet but with the freedom to work differently with residents and to innovate in local communities depending on the circumstances. Residents are treated as people rather than patients, parents, job seekers, social care case loads or victims. They are viewed not as a unit of need, but as the unique individuals they are, with a focus on what makes them special rather than what’s wrong with them.

Understanding what the community wants for social care

Listening really hard to residents, staff and stakeholders and then changing processes as a result has been crucial to the transformation. Municipal adult social care day centres and residential facilities have been replaced by vibrant community groups and supported accommodation, providing independence and higher levels of client satisfaction.

At the same time as closing these expensive, ineffective state solutions, Wigan Council invested 10 million over a four year period in grassroots community and voluntary organisations to stem, and now reverse, the rising tide of demand for adult and children’s social care and NHS services. Five hundred amazing projects support people to be mentally and physically happy and well, and socially connected in their local neighbourhoods. This is why just cutting and stopping things isn’t transformative. Rather we’ve taken money out of budgets by permanently reducing demand for expensive reactive services and have a balanced adult social care budget as a result.

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Extending the Wigan Deal into health

We have applied the principles of the Deal to children’s social care, again with amazing results as we focus not just on the child, but on supporting the whole family to be the best they can be in an asset-based approach. As a result we are seeing numbers of children in care reduce, when the national trend is going in the opposite direction.

We are now working with our NHS partners through our Integrated Care Organisation and a ‘Healthier Wigan experience’. It applies the same principles of strengths-based behaviour change, permission to innovate and place-based working to address the demand issues in health services. Seven fully integrated place-based teams combine the expertise and knowledge of local GPs, practice managers, dentists, social workers, health visitors, drug and alcohol workers, housing officers, police officers, Department for Work and Pensions staff from local job centres, community organisations and elected councillors. In the first three months of 2019, we diverted more than 2,000 individual ambulance trips away from our local A&E department by intervening with step-up and step-down beds in a local care home. This approach is much better for the patients and also significantly more cost effective.

Maintaining the focus

Ensuring the Deal applies to everything and everyone sounds really easy, but it requires tough, visceral leadership from officers and politicians to keep the intellectual coherence of the social movement and not dilute it with other initiatives. By doing that, however, 82% of residents support the principles of the Deal and, despite having £160 million less budget every year, residents are happier with a 59% increase in overall satisfaction with the council and how it does things.

If you are interested in finding out more about the Deal, culture change, place-based working or would like to book on a Deal Day please contact Alison Wright.

To get involved, join the conversation on Twitter at #ACaringSociety.

A caring society

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