The ‘system’ works well for those with straightforward single service needs (one-off illness, emergency, job loss etc) but when people have multiple and complex needs, more time is needed to consider the needs of the person in the context of their lives and experiences recognising that childhood trauma can be the root cause of unhealthy behaviours and coping mechanisms. Often such individuals need more intensive support than most practitioners are able to give – accompanying to GP appointments, making social connections etc. High Flow aims to reduce the failure demand in the system that is generated by not providing people with the support they need to live the life they want.
High Flow is a personalised and holistic support programme for the 20 most intensive users of public services in Northern Devon. The programme aims to better meet the needs of these individuals and use the learning to improve the future system response. The High Flow caseworker will have a ‘What matters to me’ conversation with the individual and co-produce a bespoke support plan which aims to support the individual to life the life they want. When required, High Flow will take a Team Around the Person (TAP) approach, gathering a multi-agency team around the individual to share actions and better support them.
20 of the most intensive unscheduled users of public services in Northern Devon who have consented to engagement with the High Flow caseworker
Northern Devon Healthcare Trust, Devon Partnership Trust, Devon and Cornwall Police, South West Ambulance Service Trust, Devon County Council, Torridge District Council, North Devon Council, Primary Care Networks and Encompass South West. In addition, other organisations are engaged where appropriate and relevant.
January 2020 to May 2021
In January 2020, One Northern Devon launched ‘High Flow’, a personalised and holistic support programme for the 20 most intensive users of public services in Northern Devon. The High Flow programme aims to better meet the needs of these individuals and use the learning to improve the future system response.
- Each person will have a key ‘supporter’ and a single plan shared with all agencies.
- Additional capacity will be provided through a High Flow Case Worker.
- Practitioners will be informed to recognise and respond to behaviours resulting from childhood trauma.
- System leaders will support staff to overcome the barriers existing in the system that prevent people getting the help they need.
- The learning about barriers and solutions will be used to influence future policy and service design for high frequency service users.
How does it work?
Recognising the need for more capacity for practitioners to spend time with individuals in the High Flow programme, a full-time case worker has been recruited by One Northern Devon following the NHS Rightcare model. In January 2020, Katie Simpson commenced in the role of that caseworker. A key difference between the High Flow programme and the NHS Rightcare HIU programme, however, is that the individuals will be high intensity users of One Northern Devon’s collective public services, not just the NHS so that it can deliver a ‘whole system approach to a whole person’.
Once an initial engagement has taken place, it will be agreed about who is the key supporter of the individual, the High Flow caseworker or the case lead from the relevant partner organisation. This will be determined by several factors but primarily about who has the best relationship with the client.
The key supporter will create Team Around the Person (TAP) either virtually or face to face. The simple idea is for all professionals to support the client, sharing actions and responsibilities to provide a creative and holistic response to the individual’s needs. This may require organisations to step out of policy or remit for the high intensity client though recognising that the short-term investment in time and resource is likely to provide a long term benefit for the individual and the organisation.