Chris Shaw – Advocacy in Wirral (CEO) Barbara Edwards – NHS Wirral Sean Harrington – Wirral CABx

1. Chris Shaw – Advocacy in Wirral (CEO) Barbara Edwards – NHS Wirral Sean Harrington – Wirral CABx

2. Driver Docs such as A better future in mind and A new vision for mental health … offered such weighty support to our aspirations at AiW by their Advocating… A movement away from the dominance of the medical model….Experts by experience taking a strategic leadership role…..Power relationships need to shift in order to give real self-determination…widening the availability of advocacy services .…expanding the role of the voluntary sector to increase accessibility and appropriateness .…a positive approach to the mental well-being of the whole population .… creating conditions conducive to good mental health ….increasing early recognition of problems and preventing escalation of problems to crisis point….Offering advice from an advocate … Moving away from the expert/patient paradigm

3. So, today – • 1. We just want to give a quick insight into the recent journey that AiW as a 3rd sector organisation has gone through. • And to see this journey through the experiences of AiW and its development of true Partnership Working with Wirral CABx. • 3. And, then to look at the nurturing of the 3rd sector, and AiW, by enlightened commissioners who took the time (considerable time!) to learn about the 3rd sector, and engage with it helping us to become credibly fit for purpose enough for the NHS to discharge its duty of care safely and also to invest their resources wisely in innovative Commissioning.

4. AiW’s Journey 1992 - 2005 Founded in 1992 by Lilian Baker (Chair) and a group of 4 other service users. We were entrusted with our first Wirral Borough Council contract in 1993 – continuously funded by WMBC ever since By April 2005 AiW’s projects were: General Community Advocacy LSC Welfare Benefits advice Hospital In-Patient Advocacy (via Lottery funding) Delivered by: 6 paid staff (5wte’s). 12 volunteers

5. 2005 - 2009 When I arrived at AiW in 2005 – The whole landscape was changing and expressions such as User Led and 3rd Sector were beginning to be terms that would be spoken about positively - and not just tokenistically PCT Commissioners were being actively encouraged to develop links and relationships with Voluntary and Community Sectors – and on Wirral – (almost) undertaking an ethnography to immerse themselves in the issues and working environments of the local 3rd and community sector.

6. Our Service Model 2009 .. • 1.Primary Care Advocacy Link (PCAL) - Wirral CABx and PCT Partnership . • Talking Changes – Cheshire & Wirral NHS Trust and Wirral Mind. • Mainstream Advocacy • Community MH (SEMI) Advocacy (DASS – Rolling Contract). • Community MH Debt Advocacy (3rd Sector Health Innovation Fund) • EMI Advocacy • Legal Services Commission Specialist Welfare Benefits Contract – (Rolling Contract) • Clatterbridge, Arrowe Park and St Caths Hospital Advocacy • Substance Misuse Advocacy (Wirral DAAT – rolling SLA) • Wirral’s - Independent Mental Health Act (Statutory) Advocacy Service • Alcohol Advocacy Grant– from DAAT/PCT • (Some) Independent Mental Capacity Advocacy on behalf of Wired. • Wallasey GP Integrated Care Organisation Advocacy! PBC • 11.Primary Care Advocacy Link (PCAL) - Wirral CABx and PCT Partnership • Building Bridges – Social Enterprise. • Wirral Bridges – Mental Health Supported Employment Project (DASS Rolling) • Wirral Mental Health Forum (PCT). • Mental Health –Psycho/Educational Training • West Kirby Self help Group (PCT Rolling). • APEx – England Athletics – c(PCT Rolling) • Woodside Positive Mental Health Support Group extended (PCT Rolling). • Woodside Women’s Group (PCT Rolling) • Beating The Blues Computerised CBT

7. Our current Staff team of over 50 paid staff and 38 volunteers are 65% Experts by Experience – ( and many of whom were also economically inactive before starting working with us) and a thus a real User-Led and highly cost effective local Regeneration success! • Our AiW team will see approaching (and probably exceeding) 3000 clients directly this year and through our Partnership Projects (PCAAL and Talking Changes) several thousand other distressed individuals will be directly supported by our staff this year. • By moving with the times into Primary Care (as well as growing our Secondary Care services)- we now employ a sizeable step 2 mental health team with: • 5 advocate therapists – part of our partnership with Sean/CAB (10 advisors) • 8 Case Managers and 3.4 STR Workers – part of our Partnership with CWPT • 2 workers and 24 volunteers – delivering Computerised CBT • 4 workers employed by our Wirral Bridges Supported Employment Scheme - in partnership with Wirral DASS. • Primary care mental health has undoubtedly been our major growth area in the last 3 years!

8. The PCAL Partnership Back in 2005 - I could see straight away that there was a “therapeutic value” to our advocacy projects. The chance to test the marrying together of advocacy/advice and rudimentary talking therapy came as a result of meeting Sean Harrington (in 2006) from Wirral CABx – This project was solely for Primary Care services and people with Depression and Anxiety (Mild/Moderate).. This innovative blend of of skills led to a truly 21st century Person Centred support model – that works very well indeed!

9. Sean Harrington – (PCAAL). • The Model = Generalist Advice + Advocacy + Talking Therapies/Emotional Support = effective support that rebuilds independence and robustness. • A Stepped approach: • Generalist Advice. • Longer term support for more complex practical issues and any resulting emotional issues. • History of The Project • History with the PCT

10. Barbara Edwards - Commissioning Intentions • My role specifically to develop services with local third sector providers. • Programme of engagement and understanding of organisational cultures, systems and processes. • Skills of workforce • Development Areas

11. Drivers for Commissioning from Third Sector- NHS Wirral • Evidence of quality services provided from existing third sector providers. • Working collaboratively with local partners to develop services. • Darzi review ‘Quality at the Heart of NHS’ • Local third sector providers such as AIW/CAB proven quality outcomes

13. Competencies

14. Together… So – I hope that this has given a view of our recent successful experiences and how innovative project ideas – if they are worthwhile and able to demonstrate the meeting of needs and prove their outcomes – can, with brave commissioning support, lead to new ways of supporting mental health without the need to overtly pathologise human mental distress or necessarily follow tired old dogmas and restrictive models. Thank-you for listening Any Questions?