Investing to save through Local Area
Coordination – As easy as ABCD?
Faculty of Public Health Conference 2017
Anne Forshaw - Senior Consultant, MEL Research
Dr Elizabeth Orton - Consultant in Public Health,
Leicestershire County Council
tel. 0121 604 4664 | [email protected] | www.melresearch.co.uk
2nd Floor, 1 Ashted Lock, Birmingham Science Park Aston, Birmingham. B7 4AZ
Leicestershire County
The Better Care Fund
Current Care Model
LAC Model
“a model of support for vulnerable people
which focuses on identifying and
supporting those who need help before
they hit crisis, and working towards
building an inclusive resilient community
around them”
The LAC Pilot (June 2015 to March 2017)
• external evaluation
• Sept 2015-Sept 2016
• inform future development and roll-out
Formative
Summative
What works
well?
Impact?
What could be
better?
Effectiveness?
ROI?
Individual
community
Health and care integration
Return on Investment?
Evaluation methodology

Comprehensive mixed-methods to enable triangulation
(difficult to be systematic / prescriptive):
1.
2.
3.
4.
5.
6.
7.

Familiarisation: what is LAC; what does it do?
Evaluation Framework design
Set up and embed evidence gathering systems (‘data-light’
intervention)
Maximise quality and value from LAC data – Outcomes STARs
Primary data collection
Fit-for-purpose Forecast SROI replicating a methodology used in
other LACs. Incorporated Leics LAC-specific data
Overview of LAC’s strategic impact (LAC Manager)
Three reporting updates, one final report – evidence and
learning into practice as Pilot developed
The Outcomes STAR
1 – Cause for concern
2 – Talking about it
3 – Meeting basic needs
4 – Choice and control
5 – As good as it can get
Evaluation results: i) LAC activity
 LAC worked with (up to Sept 2016):
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Referrals:
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Approx. 1,498 beneficiaries
A higher proportion of Level 1 (signposting n=963) than Level 2 (more
intensive support n=467) beneficiaries
White British; females; older age groups aged 50+
510 referrals to LAC from other agencies
395 referrals from LAC to other agencies
Approx. 174 beneficiaries were supported to access benefits
Data capture:
•
Approx. 520 Outcome STARs completed (NB. varying completeness and
quality; lack of ‘before’ and ‘after’)
Evaluation results: ii) LAC measurable outcomes
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
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Individuals to a good extent: improved quality of life; improved MHWB;
reduced social isolation; support with debt / finance; independence at
home
Health and Care Integration to a moderate extent: reduced pressure on
other services e.g. ASC; support in ‘system’ navigation; linkages and
referrals between groups and networks
Community to a lesser extent
Limited success re. Better Care Fund
Positive Forecast SROI ratio of £4.10 in accum. benefit for every £1
spent (based on 15 months of input and activity June 2015 - Sept 2016)
Key findings & recommendations at a glance
Most successful elements
Considerations - improvement & roll-out
Relationships – trust, flexibility, networking.
Not time-bound
Promotion and awareness raising of LAC
Coordinator knowledge of local assets and
matching - ‘a good life’
Showcase achievements; better explanation
of what LAC is and does
Coordinators based in local communities
Clarity - interface of LAC with partners
Lack of agenda / remit – less threatening,
‘whole-person’
Strategic planning and the ‘LAC vision’ (vs
operational delivery)
Avoidance of over-reliance
Manage commissioner / partner
expectations – not ‘investment in /
outcomes out’; evaluation data is different
Innovative use of social media (Facebook)
Reported measures to show impact;
Knowledge Management System
Evidence into Practice
 LAC is a successful and cost-effective way to deliver
preventative individual outcomes and reduce public
service use
 Changes to delivery:


Enhanced data capture
Training for team
 In data capture
 In definitions of Level 1&2 beneficiaries
 Business case:
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Used SROI for investment case
Further rollout to cover 78% of County
 26 Areas, 18 Coordinators
 Awareness of LAC to partners (promotion)