This month, Nesta’s Health Lab, together with our partners SCIE, Shared Lives Plus and PPL, published a new report, Growing innovative models of health, care and support for adults. The report explores what a truly person- and community-centred system of health, care and support would be like for those who use services and their carers.

Map depicting a future place where innovative models of health, care and support have been scaled up - from ‘Growing innovative models of health, care and support for adults’, SCIE, January 2018

The report draws on much of Nesta’s work on health, including Realising the Value, and our experience of helping innovations to grow through the Centre for Social Action Innovation Fund. It also includes examples and stories from some of the innovations in ageing we are supporting to scale across the UK, as part of Accelerating Ideas, our partnership with the Big Lottery Fund. These include:

• The Cares Family, which creates community networks of young professionals and older neighbours who hang out and help one another;

• British Red Cross’ First Call - Support at Home, which supports vulnerable people to recover from a crisis and remain independent at home for longer;

• British Lung Foundation’s Integrated Breathe Easy peer support programme for people with chronic lung conditions; and

• Shared Lives Plus, the national membership body for Shared Lives carers and schemes. In Shared Lives, a Shared Lives carer shares their home and family life with an adult in need of care or support.

Our report with SCIE and partners, proposes the key success factors that enable innovations to scale their work and impact. These include:

• A shared commitment to embedding person- and community-centred ways of working across the system, as illustrated by this model, developed through Realising the Value:

An illustrative person- and community-centred model - from ‘Realising the Value - ten key actions to put people and communities at the heart of health and wellbeing’, Realising the Value, November 2016

• Co-producing services - putting the people with the greatest stake in services at the centre of their planning and design.

"When we started to build South London Cares, after the success of North London Cares, we couldn’t just take the model and plant it across the river.  We needed a whole new set of people with local community experience and local community ties, who were excited to do this kind of work, and with new ideas on what would make it successful" (Alex Smith, North London Cares).

• Using an evidence-based approach to commissioning to ensure that resources are directed into the approaches that work effectively and achieve impact.

“In Stockport, we were not afraid to decommission 70 VCS organisations on the same day, in order to generate a new collaborative approach, using Alliance Contracts, working to a common vision and outcomes, in contracts which stress trust and integrity. Alliancing redefines relationships; it’s about alignment around a common vision, trust and working collaboratively to shared outcomes; together the sector is more than the sum of its parts” (Nick Dixon, then of Stockport MBC, a Centre for Social Action Innovation Fund grantee).

• Having leaders who are collaborative and convening.

"I frequently meet visionary senior leaders who assume that key systems… will align around the goals they articulate.  This only happens when those leaders are willing to follow through on the detail: this is a willingness to step outside of being ‘strategic’ at times" (Alex Fox, Shared Lives Plus)

• Being rigorous about monitoring data and outcomes and being willing to use this information to drive change. Over the past year, NPC has been working with Nesta and the Big Lottery Fund as the learning partner for Accelerating Ideas. This has included supporting innovations to develop and change the way that they assess and use information on an ongoing basis to support the improvement and growth of their work with older people and volunteers.  This has not always been easy -  typically, when we start working with organisations that are trying to grow, we find they are mainly interested in ‘proving’ themselves to funders and stakeholders, but this is really only one element. Rather than seeing research as an end to a means (for example, a robust impact evaluation at the end of the programme), NPC has encouraged a shift in how the eight organisations assess and use information on an ongoing basis - in a way that can support both the improvement and the growth of services.

The projects we are supporting through Accelerating Ideas are not only diverse in their approaches and target groups, but also in terms of their stage of innovation, size of organisation, and their current UK reach. This gives us a unique opportunity to test the success factors outlined above and to continue to explore how these innovative approaches can be supported to scale and grow for the benefit of people and communities. We will continue to share this learning to help build the evidence base and support others to grow innovative models of health, care and support.