In systems change we regularly talk about activating levers and making interventions. What we really mean is ‘doing something’. But I’ll qualify that by saying it’s doing something that we think will help us make a change, assist in getting us where we want to get to. I also talk a lot about picking a thread to pull with the analogy of undoing a hard knot – the kind where it’s really difficult to see which bit of it needs the attention and work to be unpicked first (shout out to the laces on my winter boots).
Our work with colleagues in West Dunbartonshire this year is focused on taking action to collaborate better across services and organisations through social care and support commissioning. So far we’ve been learning about how people with different roles are seeing ‘the knot’ of getting the right support to people at the right time, hearing what influences their approach to unpicking it, and sharing these perspectives together.
We’ve seen there are ways in which people in different parts of the system can connect to better support each other in tackling the problem, but also need opportunities to ask and find out – what are the pressures and priorities that your colleagues in other teams, organisations and services are working with?
Going into autumn we’re moving ahead with developing an outcomes-focused framework for adult community-based care and support. Pulling on this ‘thread’ of the knot can’t and won’t fix everything at once, but it could help to create the right conditions for more positive change by:
- Developing the framework collaboratively
- Agreeing outcomes that are proportionate, measurable and focus the system on impact
- Minimising unnecessary process
- Avoiding making a framework that is long, over-specified or difficult to understand
It’s a practical step that’s being taken by motivated people who want social care and support to be as good as it can be. We’ll update as we make progress, and in the meantime keep working on connecting, collaborating and making sense of how we unpick the knot.