Getting started - partnership, coproduction and defining the problem
The Counting Every Adult service (CEA) has been operating in Cambridgeshire since February 2011. The partnership initially came together to consider the escalating problems of one individual in Cambridge City. By working together a solution was found that made a significant difference to the life of this individual and their health, housing, ASB, alcoholism and drug misuse and vulnerability to exploitation. At the same time, an analysis of premature death at the GP service for homeless clients was included the Cambridgeshire JSNA and a resulting strategy committed Cambridgeshire to exploring coordinated approaches. An Operational Group of service managers and a Governance Group of commissioners oversees the CEA service.
Designing your intervention
The CEA service employs two coordinators who have no remit other than to the client and have the authority to explore innovative approaches for individuals. They work to the client’s wishes within the boundaries of law, individual safety and social expectation, using a person centred approach. Case co-ordination continues until the client can maintain progress without CEA intervention. This can be a short period but may also involve support over a number of years. Flexibility from services is vital. All involved want the best outcome for that client and having a co-ordinator with a direct link between client and commissioner can help ensure positive outcomes.
Sustainability and system change
The CEA service is seeking to sustain both the practical coordination it offers and the flexibility from local services. In recent years it has been grant funded by Public Health and Cambridge City Council, making up the shortfall via different one off grant applications to a variety of organisations. We are currently exploring with strategic leads in public services how the service shortfall can be filled on a more permanent basis and how the service offer could be enhanced. We are also reviewing the current Governance arrangements to maximise the impact that this service has locally and ensure flexible practice becomes the norm not the exception.