Flexible responses from services

A successful MEAM Approach area will:

Recognise that coordination won’t work unless local services provide flexible responses that promote equality of access for all. There are many different ways to achieve flexibility in local areas including cultural, strategic, commissioning, economic and legal approaches. Most MEAM Approach areas will use a combination of these.

Recognise the importance of culture change at all levels and ways in which this can be achieved. Working closely with experts by experience can help with this, as can promoting an understanding of the impact of trauma and strengths-based approaches. Without working closely with those who have accessed services, partnerships risk repeating previous assumptions which may have left people excluded or unable to access support.

Consider developing a strategic board of senior individuals to oversee a coordinated intervention. The board can troubleshoot, fundraise, share data and give permission for things to be done differently in frontline services.
Consider developing an operational group of service managers and practitioners that can provide a forum for case conferencing, for agreeing shared support packages for individuals and for supporting each other to work more effectively together.
Recognise that for both boards and operational groups, local areas may wish to utilise existing forums rather than setting up new structures, but that it is important attendees have enough time to dedicate and that they are willing to adopt new ways of working.

Consider how flexible responses can become part of commissioning and service contracts. Some MEAM Approach areas have successfully included coordinated ways of working into commissioning contracts, so that providers are required to respond flexibly to individual needs rather than sticking rigidly to fixed criteria and thresholds. Local areas should ensure the involvement of people with experience of multiple disadvantage in all stages of the commissioning process.

Explore different financial approaches. For example, pooled budgets can allow different commissioners to contribute to the shared outcomes (either equally or based on savings made); individual budgets can allow services to be purchased for people based on their needs; alliance contracting can procure a system of services from a group of providers working collaboratively to achieve shared outcomes in partnership with commissioners; and social investment can incentivise providers (or a group of providers) to deliver services that meet a set of locally agreed outcomes.

Consider relevant legislation and its impact. In some circumstances people experiencing multiple disadvantage will be protected by certain legislation and in other circumstances legislation may serve to exclude someone from much needed support. The partnership should consider its response both to meeting statutory requirements under relevant legislation, but also to acting outside of legislation where it is necessary to meet the needs of the individual.

The MEAM Approach