All in A Day’s Work: Mental Health Provision, Wellbeing and Scrutiny in Brent Council

Cllr. Ketan Sheth

As Chair of the Community and Wellbeing Scrutiny Committee at Brent Council, Cllr. Sheth has a behind the scenes look at the workings of local government. Here he shares his experience in trying to improve Brent’s mental health provision and his views on what good local authority overview and scrutiny looks like. 

One in four people will experience mental ill health at some point in their lives – so it is likely all of us will directly or indirectly need support from the valuable services that support people to recover and to remain resilient.

Mental health – a once under-reported and some would say under-valued aspect of our health and wellbeing – has been making headlines recently and is a stated national priority. Earlier this year the Prime Minister announced plans to transform mental health services with a particular focus on children and young people. This was subsequently followed by an announcement last month by the Health Secretary of a plan to create 21,000 new posts, investing £1.3bn by 2020. Again, the commitment to mental health services for children and young people was affirmed.

This brings a welcome focus given children and young people’s mental health and wellbeing can ultimately shape their life chances and outcomes. So now we must think about how we – as a local authority overview and scrutiny committee – understand what is going on behind the headlines and – as elected councillors – continue to shine the spotlight locally.

Scrutiny work that adds a real value and makes a positive difference to local residents’ lives must remember a number of important factors: are elected councillors supported to carry out a meaningful review? Do they understand how to capture the service model? Do they understand how to draw out the challenges to effective delivery of that model? Do they have the tools and information they need to be responsive local decision makers?

In Brent, my Community and Wellbeing Scrutiny Committee recently went behind those headlines to better understand mental health provision for children and young people across Brent and to see how we might add value to the current service model. A Task and Finish Group on Child and Adolescent Mental Health Services (CAMHS) was set up to review this complex area, and their report makes for very interesting read.

The task group was put in place to gather evidence – qualitative evidence from face-to-face interviews and research, and quantitative data and this was done alongside NHS Brent CCG, local health providers, schools and further education representatives and community representatives. I want to highlight two things my committee learnt in undertaking this work.

Firstly, the involvement of young people in this research was vital. Let’s face it, elected councillors in a local authority tend to be far older than the demographic we were seeking to reach, so it was incredibly helpful to have the input and perspectives of young people. We appointed a former member of Brent Youth Parliament (now a student at King’s College London) and they brought an excellent viewpoint to the task group’s work and deliberations.

Secondly, it was essential we recognised and embraced the complexity of this area. CAMHS is a complex and challenging subject for overview and scrutiny members because it cuts across local government and health responsibilities. Whilst this is excellent news for integrated care, it means you must be able to grasp and work across a range of people and organisations. You must also recognise the child or young person and their family and carers are a vital part of this system and network of care, and understand their perspective as well.

Effective scrutiny can be a powerful vehicle for change if committee members can stand back and really understand what is happening across local government and health services. If we are honest, overview and scrutiny committees nationally have varying relationships with public sector colleagues; however, in Brent, my committee’s relationship with NHS Brent CCG and wider health services is a good one. We try to be constructive and fair in forming our recommendations, especially in areas where we think things could be done differently and outcomes could be improved.

We have now made our recommendations to the Brent Council Cabinet and NHS colleagues and will monitor progress as a result. In Brent we will ensure mental health for adults and children and young people remains on the agenda, irrespective of the headlines.

To read the CAMHS task group report, visit http://www.brent.gov.uk/scrutiny.

 

 

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Cllr. Ketan Sheth is a Councillor for Tokyngton, Wembley in the London Borough of Brent. Ketan has been a councillor since 2010 and was appointed as Brent Council’s Chair of the Community and Wellbeing Scrutiny Committee in May 2016. Before his current appointment in 2016, he was the Chair of Planning, of Standards, and of the Licensing Committees. Ketan is a lawyer by profession and sits on a number of public bodies, including as the Lead Governor of Central and North West London NHS Foundation Trust.

Why do we need a new model of public services?

Catherine Staite

Public services, including those commissioned and delivered by local government, have changed substantially in the past ten years. There have been changes in service delivery mechanisms, in relationships between users and services, in organisational structures and in partnership arrangements. It appears likely that the next ten years will bring at least as much change, if not more. One thing is clear: the old model of public services – people expect and services provide – is no longer tenable.  The growing gap between demand and resources has been described in terms of ‘the jaws of doom’.  That is one way of looking at the future.  Another way is to see the opportunities which we have to renegotiate ‘the deal’ between people and public services.

INLOGOV is working with a wide range of local authorities and other bodies to test a new model of public services. The model draws together many of the themes in current debates about the ways in which the public sector is likely  to have to change, in particular, how public services can manage demand, build capacity and achieve better mutual understanding, through the development of stronger relationships with communities as well as through co-production and behaviour change.  The purpose of this model is to support public service leaders – both political and managerial – to make better sense of a complex world.

INLOGOV’s model brings together the disparate cultural, structural, political and financial challenges facing local government and wider public services into an integrated framework, which takes account not only of individual drivers of change but also of the inter-relationship between changes in public services and the wider political and social context in which those changes are taking place. If we have a coherent model which reflects current and future realities it will be easier for us to explore possible solutions together.

We have concentrated on the challenges and opportunities for local government, in partnership with other local and national institutions.  That is not because we think local government is the most important player on the public service stage, it is because we think it plays a unique role as a convenor and mediator between conflicting interests within complex networks of players.  It is in this role that it can provide the creativity and connectivity to help shape solutions to the seemingly intractable problems of rising demand and falling resources.

The key drivers for a new model are: building stronger relationships with and between individuals and communities, increasing co-production of better outcomes by focusing on capacity, as well as need, and changing expectations and behaviours.  Before we can deliver these benefits we will need to change the way we think, plan and act.  There are many good, small scale examples of innovation which are delivering real change but now we need to scale up change to have a real impact – reducing dependency, building confidence and improving outcomes.  These are not quick fixes, so the sooner we start and the more energy we invest the sooner we’ll be able to achieve a sustainable relationship between public services and the communities they serve.

 

This blog post summarises some of the key messages in:

Why do we need a new model for public services? By Catherine Staite

Ch. 1 in Staite, C. (ed.)(2013). Making sense of the future: can we develop a new model for public services? (Birmingham: University of Birmingham/INLOGOV).

Catherine Staite

Catherine Staite is the Director of INLOGOV. She provides consultancy and facilitation to local authorities and their partners, on a wide range of issues including on improving outcomes, efficiency, partnership working, strategic planning and organisational development, including integration of services and functions.

Local elections: challenges and opportunities for new administrations

Catherine Staite

Following the elections, both new and continuing local authority administrations, of all political hues, will face significant challenges. The ‘irresistible force’ of increased demand is meeting the ‘immovable object’ of financial stringency, creating an annual cycle of despair, where councils struggle to do ‘more for less’ – something which becomes progressively hard to achieve. Many will manage to balance their books till 2014 but face a financial cliff edge thereafter.

These apparently irreconcilable pressures may actually be the saving of local government by creating pressure for change – if it can reimagine and reinvent itself. What local government need to do in response to these challenges is less important than how it needs to be.

Councils are moving to commissioning from direct delivery, to supporting independence rather than dependence and to better understanding of the capacity of communities to improve their own lives. Local authorities are good at working in partnership – with health, the police, education and business. They need to get three other key relationships right; with the communities they serve, with each other and with central government.

Local authorities need to develop a more sophisticated understanding of the diverse and complex capacities and needs of their communities. Engagement should be woven into the fabric of local government. There is a wealth of evidence that shows people do know and care about their local services. Without this public support no real transformation of local areas and services will be possible. The relationship between local authorities and their communities should therefore be less benefactor-to-beneficiary and more partner-to-partner – underpinned by mutual respect.

Many local authorities already work collaboratively to bring down costs and improve quality. This patchwork of ad hoc arrangements is often driven by enthusiastic individuals and is consequently fragile. Cooperation between local authorities is too often constrained by parochialism and soured by old rivalries, too much defending of council’s sovereignty and not enough drive to deliver efficiency and improved outcomes. The experience of successful collaboration tells us it should be the norm and not the exception. Councils will have to explain why they are cutting services or ceasing to invest for the future before doing everything possible to reduce costs and improve outcomes by working together.

The relationship and the balance of power between central and local government generates much debate. We have the most centralised model of government in Western Europe. Central government demonstrates a lack of trust in local government and an abiding reluctance to devolve financial control although they delegate to councils the implementation of their funding cuts. If central government acts like a disapproving parent, local government is likely to act like a recalcitrant child. Neither set of behaviours will deliver the outcomes that the Coalition and local authorities want to achieve for the people they are all are supposed to be serving.

It is time for local government to take the initiative in reshaping their relationship with communities, each other and central government. Local government is remarkably efficient and reliable. Serious service failures are only newsworthy because they are so rare. That competence confers authority and local government needs to get off the back foot, stop waiting for the green light from central government and make the changes needed to meet the challenges of the future.

Catherine Staite

Catherine Staite is the Director of INLOGOV. She provides consultancy and facilitation to local authorities and their partners, on a wide range of issues including on improving outcomes, efficiency, partnership working, strategic planning and organisational development, including integration of services and functions.

The balance between electability and visibility

Ian Briggs

Much has been made of the challenge of actually getting people to vote. The November 2012 Police and Crime Commissioners elections had a pretty dire turnout and there may be some particular issues with regard to that election; but the May 1013 local elections are somewhat different. The three major parties are turning their attention to the next general election and on the back of the Eastleigh By-election the UKIP vote is attracting some attention.

But beneath all of this we need to look more closely at some of the basics of campaigning. Political parties are not swimming with cash at the moment – resources are limited and if the truth be told nearly all parties are short of volunteers to support local campaigns.

Some recent research suggests that over 85% of the UK population have some form of internet connectivity – this of course does mean to say that all are effective users of web based communications. Can the political parties rely more on web based media, social media and electronic campaigning?

In conversations in social settings and when travelling to and from work, it is not that people are wholly disinterested, but rather it is that they say they have few opportunities to actually see the whites of the eyes of the candidates. In more concentrated urban areas it might be possible to do more door to door work but the cost and the time involved to go door knocking in dispersed population areas is a big issue for many candidates – especially as this week’s election is for mainly upper tier councils that cover significant geographical localities. This assumes that all candidates are sound of wind and limb.

A recent conversation with one candidate – a 76 year old widow – revealed that she has little financial support from her party and finds getting about a challenge. Should this in any way detract from her worthiness to stand, her ability to engage in local political and community activity? The answer has to be no, if we believe in local democracy, yet her visibility to those who she is wishing to represent is in marked contrast to the early 40s male candidate who has employer support to stand and whose political career may even enhance his professional career. He also has extensive skills to use web based and social media and can easily find the time to go from door to door in dispersed rural communities to actually talk to local people. He accepts that for many – but not all – it is the policies that he is promoting that are attractive to the electorate and not his shiny German car and sharp cut suit.

If the many who do not have strong political allegiance walk into the polls willing to vote (assuming they have the time and motivation to do so), are they more likely to offer their vote to the individual who has actually taken the time to talk to them on their doorstep? If your telephone has rung and you have been asked if you are going to vote and if so for whom, might it be the one who stood on your doorstep and engaged you in conversation? Do we think enough in the lead up to elections about who are selected to be local candidates and whether there are any inherent inequalities in the way that candidates are selected?

It might just be that sometimes the best candidates, irrespective of their party, might be the better ones to have irrespective of their politics.

briggs

Ian Briggs is a Senior Fellow at the Institute of Local Government Studies. He has research interests in the development and assessment of leadership, performance coaching, organisational development and change, and the establishment of shared service provision.

Councillors: Engage more and engage differently, but not at the expense of the basics

Karin Bottom, Catherine Mangan and Thom Oliver

This month saw the ‘Communities and Local Government Committee’ release its report on the role of the modern councillor. Focusing on  the impact of the Localism Act (and associated  developments in recent years),  Clive Betts MP,  Chair of the Committee,  suggested that local representatives are now spending less time in council and more in the community. As a result, they now shoulder the majority of responsibility for ensuring that  that their local communities have the tools to make the most of the localities in which they live. While the Report’s findings held few surprises, it did suggest that those we elect to be the local democratic voice of our communities must embrace this challenge and meet it head on. This position resonates with early findings from an INLOGOV project concerned with local engagement and the role of the local representative.

Firmly grounded in the belief that councillors’ responsibilities and remits vary, the current climate suggests they require a more nuanced and responsive skill set than ever.  In this sense, elected representatives must be outward looking, open to new ideas and welcoming of new approaches, but they must take care not to throw out the baby with the bath water.  Instead, our research suggests that what councillors need to do is integrate new learning into their existing repertoire of behaviours, while at the same time being more dynamic and responsive in their increasingly frontline role.[i]

For respondents, one of the main challenges they felt they faced was engagement. Whereas it is natural for all councillors to ‘do engagement’, a variety of approaches were evident in our research and for those who had moved into executive positions, the role shift was accompanied by community activities having to be curtailed. Respondents were very clear that the Localism Act was beginning to have an impact, for example in the mediating role that  has now been allocated to councillors: this meant developing skills as a community organiser and ultimately being on top of a great volume of information while managing a number of resources and contacts. This form of community engagement, though hard, was thought to have clear  rewards: a number saw the benefits of having shared aims and  a deeper understanding of the people they represented,  which in turn provided greater insight into the experience of being on the receiving end of council services; in contrast others thought wider community engagement created opportunities to lead opinion and ultimately change behaviour, for example one councillor worked with environmental groups to shape the ward’s attitude towards refuse collections and recycling.

Our interviews also surfaced information suggesting that that the majority of traditional communication methods continue alongside a slow evolution to greater online engagement and use of social media. While one councillor referred to sending regular email shots and creating a web page to articulate local information, activities and updates,  another described  how Facebook had enabled him to engage with people – often young people – who  generally chose not to participate in politics and local policy conversations. Finally, a number of councillors explained that twitter enabled them to aggregate opinions en mass, engage in debates and learn information they would otherwise be unaware of,  while some with cabinet responsibilities stated that this particular medium was unique in that it enabled them to keep on top of their portfolio while also providing opportunities to build and consolidate relationships they would otherwise not have had time to address..

One factor that was evident in almost every interview was that councillors always needed to be aware of the bigger picture: different methods worked in different situations and knowing a ward’s story or the history behind a particular community group could make the difference between successful and unsuccessful engagement. Just because a particular approach might work in one instance, there is no assurance it will work in another, despite apparent similarities. So, while councillors may see their responsibilities increasing and their community role broadening, it is vital that they maintain depth in their representative activities: if they don’t, potentially successful initiatives run the risk of failing.  

The authors are grateful to the School of Government and Society, University of Birmingham, for providing funds to assist in this research. With thanks also to NLGN for their contribution to this work.  For further information about the research project, contact Karin A. Bottom: k.a.bottom@bham.ac.uk

bottom-karin

Karin Bottom is Lecturer in British Politics and Research Methods at INLOGOV, University of Birmingham.  Her core research areas comprise parties (particularly small and the BNP), party systems and party theory.  She is particularly interested in concepts of relevance and how national level theories can be utilised at the sub-national level.

Portrait of OPM staff member

Catherine Mangan is a Senior Fellow at INLOGOV.  Her interests include public sector re-design, outcomes based commissioning and behaviour change.  Prior to joining INLOGOV she managed the organisational development and change work for a not-for-profit consultancy, specialising in supporting local government; and has also worked for the Local Government Association, and as Deputy Director of the County Councils Network.  She specialises in adult social care, children’s services and partnerships.

thom

Thom Oliver is a Postdoctoral Research Fellow at Oxford Brookes Business School.  He completed his PhD, exploring the representative role of councillors on appointed bodies, at INLOGOV in 2011. He currently lives in Bristol and has recently rejoined INLOGOV as an Associate.  Follow his Twitter account here, and read his own blog here.


[i] Research to date provides initial findings from interviews in three councils (one London Borough and two Metropolitan).  Interviews comprised a broad mix of age, seniority, roles and experience. Approximately equivalent numbers of men and women were interviewed.