Three conversations at Medway Council

On 6th October, I received an unexpected call from a colleague.  They had an opportunity for me, “did I want to work for a company that really listens to what people need?” Of course I did!

During October to December, I spent time getting to know a little more about the Partners4Change 3Conversation model, helped to design and create some tools to support the work, and met the team for a Karaoke session and a few Christmas drinks in London.

On the 4th January, I started my first change partnership with Medway Council in Chatham.  What a welcoming team!  Sam Newman (Director for P4C) and I held some initial planning sessions called “Kick off sessions” to explain the 3Conversations and its basic, fundamental rules.

Here are the 3Conversations ground rules:

  • No waiting lists, “hand offs”, “triage”, referrals or allocations.  There is no compromise on this.

  • Never ever plan long term support with people in crisis.

  • Use conversation 2 to work out how best to help someone in the short term out of crisis.  Do whatever it takes.

  • Conversation 1 – If you are working with somebody through a crisis, stick to them like glue to make sure the plan has the best chance of working and succeeding.

  • Conversation 2 – Make small amounts of money easily available to staff as an alternative to long term care.

  • It is crucial that you are aware and knowledgeable about the neighbourhoods and communities that people are living in.

  • We are not the experts – people and families are.

  • A shift away from the traditional concerns around ‘eligibility’.

  • Collaboration is at the very heart of our work.

The model’s ground rules often present a challenge due to the fact that we have spent so much time in the ‘assessment factory’, ticking boxes and making assumptions about the services required.

The Medway team are really passionate about having better conversations which focus on the whole family and community environment as a whole.  They have not made assumptions, and are really listening to what people need and want. As a result, they are offering solutions which help to prevent and delay the need for longer term care and support.

We kicked off the Medway innovation site on the 13th March taking people from the ‘front door’ who all came from one particular post code – ME4.  The first few weeks, like any new change project, didn’t go without some challenges.  It’s like starting a new job, it’s a significant move from the old to the new!  It’s not easy and it’s a journey.

In weeks one and two, it is fair to say that the flow of calls were not as high as expected, so within the framework of the model we agreed that we would ‘turn on the tap’, and ‘turn off the tap’ as much as needed to ensure the right level of work.  We did exactly that, adding another postcode area – ME5.

We are now in week five and the team reported some clear and powerful stories of difference along with data collections which showed signs of improvement with some early examples of cost avoidance.  We talked about the barriers and challenges so far, and we are co-designing solutions to make things easier for the team.

And finally, to finish off – one story.  One of the Medway innovators took a call from a sister who was ‘petrified’ about the wellbeing of her own sister – who she felt had become reclusive, not allowing people in to her house, withdrawing from support and in clear distress.  It was clear from the history that these two people had been bounced around the health and social care system for a while – with no-one taking responsibility or actually listening or doing anything. There is no easy solution,  but at least in an environment where we are no longer allowed to refer people away, or hand them off to other members of staff or teams, the sister is now being listened to properly, we are sticking to her ‘like glue’ and a plan is being put into place that supports the first sister, and will enable her sibling to get the health response she needs.

We will provide another blog update with more data and people’s stories in the near future.

Well done Team Medway.  More biscuits and cakes on their way!

Natasha Burberry, Change Partner, Partners4Change