Time to reflect

imageedit_2_2943619497Following our recent visits to Staffordshire as part of the Centre’s work on the ‘Troubled Families Health Information Sharing Project’, Barbara Hine (Building Resilient Families and Communities Co-ordinator in Staffordshire) has written a guest blog for us on her experiences in recent months:

‘When I was first approached by the national Troubled Families team at the Department for Communities and Local Government (DCLG) to be involved in this project about information sharing, I was really pleased that my team, our partners in Staffordshire, and the Building Resilient Families & Communities (BRFC) programme we’ve created were being recognised as an area to share ‘good practice’. I was keen to share our knowledge and lessons learnt with the Centre so they could disseminate this good practice on our behalf. My hope was that other Troubled Families teams located across the country would benefit from our experiences – especially if they are grappling with similar issues around sharing mental health information that we ourselves have learnt from.

To be completely honest, I wasn’t sure what I’d get from speaking to the Centre, (other than that warm fuzzy feeling of being able to help others by sharing our learning!) but on reflection, I feel we have gained a very valuable insight into the information sharing challenges that will inform the way forward for our own programme too.

Initially I had a telephone interview with one of the Engagement Managers from the Centre which helped to shape their background research, and we arranged for them to meet and conduct some semi-structured interviews with members of my team and representatives from the other council services and partner organisations we work with. These interviews and their semi-structured approach gave staff the opportunity to speak freely and so provided the Engagement Managers with the information on the key people and behavioural factors that impact on, and enable our information sharing.  The Engagement Managers then wrote up their findings and visited again a couple of months later to follow-up on any further opportunities and discuss our priorities and ideas for moving forwards.

As an independent third party, the Centre were able to bring in the individual components of the programme (e.g. Public Health and Mental Health) and ask the questions of them which may not have been so easily asked by myself or even so readily heard by some partners.  It also gave partners the chance to think more deeply about their contribution to the BRFC programme and their issues relating to information sharing. I really valued this as it felt like we had a critical friend who could be objective and yet they still understood the challenges we face. They could also share with us their perspective and knowledge which has been informed by their experience of how other partnerships from different local places and who are working across a range of different policy areas (not just on Troubled Families), are developing information sharing.

Having a third party do this for us, gave me the opportunity to stand back and take a wider view of the health agenda, the landscape it sits in and the complexities within it. Even though we’ve already got really good working relationships with a number of health partners that supports information sharing at the front line, I think the interviews have helped us both to become more engaged.  It has also framed our work in a wider strategic context which has helped strengthen the link between the front facing BRFC operation, through to the higher Children’s Service transformation agenda.

On reflection, it’s easy to get bogged down in the detail of the day-to-day work, and sometimes you don’t realise what you have already achieved. The Centre’s approach has helped me to reflect and look at the distance we’ve travelled in developing information sharing between BRFC and our mental health partners.  Even between the first and second meeting with the Centre, we’d made significant progress by completing the first phase of our approach to sharing mental health data that has enabled us to identify those families with a mental health criteria and who can then be assessed for their eligibility for the BRFC programme.

Following this experience of working with the Centre, I’d wholeheartedly recommend that other local Troubled Families programmes try to create some space and time to reflect on your approach to how you have developed information sharing, recognise what you have achieved already, and listen to your partners about what has been learnt and how you can move forwards.

Anyone who works in a Troubled Families team will understand the complexities of the programme, and on speaking with the Centre, I’ve realised that we started off by developing our information sharing with the partners we know best, and in the spaces we were more confident about working in. It seems obvious at the outset to start with ‘what you know’ but it made me realise that as the health landscape was less familiar this had meant that information sharing with health had been placed in that initial ‘too hard to do’ pile. Our conversations with the Engagement Mangers helped me to understand that it is a case of ‘breaking it down’ into smaller chunks – this enabled us to identify our priorities and focus in on what we need to do next.

If I had to give a piece of advice to any other Troubled Families Co-ordinators reading this, I’d say that your partner’s information governance officers are key to unblocking information sharing barriers for you, so if you build solid relationships with them, that will really help drive the programme forward. You do also have to be tenacious though, and be prepared to have the same conversations several times before people sometimes understand, or ‘get’ information sharing.  Having the right leadership and governance which supports the programme really helps this dialogue. For example, our leaders in Staffordshire have really been on board with the programme and we have the Chief Executive from Tamworth Borough Council as the chair on our leadership board.  This gave it the seniority it needed to support the development of information sharing. Through our governance review we are now bringing the BRFC and Children’s Service Transformation agendas together which means BRFC can capitalise on the existing good health representation we have on the Transformation Board and enable us to speak with ‘one voice’ on the shared vision for the sharing of health information.

In terms of going forward, and the impact on information sharing – I think DCLG have done a really good job in terms of supporting the Troubled Families programme and crucially they have provided the platform of legal information sharing gateways from which we can work off.  This has given us both the confidence to lead BRFC and credibility in the eyes of our partners, enabling the necessary discussions at a county level to take place and set out how information sharing needs to happen.

What do we need now?  Well, I know we’d all benefit from more joined-up working between government departments as it makes joining-up services at the local level and developing the information sharing to support the delivery of these so much easier.  We want to see more of this happening between all departments; we have seen the impact it can have through the Department for Work and Pensions brokering of information sharing which has proved invaluable, as has the Department of Health guidance for health partners on sharing health information with Troubled Families.  These have both really helped to make information sharing happen.

Finally, speaking from a local authority’s perspective – we receive different strands of work from different government departments. If you’re in a small unitary authority, different funders and policy come to either one person or a small team so it’s easier to keep track, see the synergy and how information sharing can support delivering against these. However, in a larger shire authority, the work fits in with a lot of different work streams, for example I’m currently reading a document about drugs and alcohol – this would initially fall on the desk of Public Health, but because of the content it also links strongly to Troubled Families. The risk is that without ensuring these policies and initiatives are properly joined-up at source, then partners and different services can end up actually competing against each other which presents real barriers to information sharing.  Therefore, we need to develop the synergies to avoid duplication, move away from silo working and develop better and more effective information sharing which will ultimately improve the lives of the families we are supporting.’

The Centre are currently writing a case study to help other troubled families team learn from Staffordshire. This will be published late 2016/early 2017, please watch this space to find out more.

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