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Manchester Local Care Organisation: I’ve got a good feeling about this

29 Mar 2018 - 15:55 by Mike Wild

About a year ago, I wrote a blog which focused on the development of the Manchester Local Care Organisation. Its subtitle was Episode IV: A New Hope. Now that the LCO is officially launching on 1st April, I’m finding myself wondering what this moment actually means? And which bit of Star Wars is it?

Certainly it doesn’t signify the completion of a transformation programme and nobody would claim it does. That’s a long time in the future. So we havent yet destroyed the Death Star. Equally this isn't the beginning of the story: for those who've been working on setting up the LCO, navigating all the complex technical processes must have been stressful and hectic at times. I know there has been a lot of hard work to get to this moment. And you thought The Phantom Menace was hard work….

I think – and I’m really giving full rein to my geek here but go with me – that this moment is the equivalent of that bit in Star Wars where Luke is trying to use a lightsaber for the first time. If you remember, he starts off practising by trying to react as fast as he can to the little flying ball which is firing laserbolts at him. He has some success but eventually gives up in despair. Obi Wan Kenobi puts a helmet over his head which blocks his vision and tells him to try again. He will have to use new skills – ones which he doesn’t realise he already possesses. That’s where Luke first gets his first real experience of what it would actually be like to be a Jedi. It’s not the first step and there is an even longer journey ahead, but it’s the moment that Luke’s future as a Jedi Knight becomes not only possible, but likely.

From April onwards, the Manchester Local Care Organisation (now its official name) starts to take over the running of certain aspects of health and social care in the city. The focus initially is on the safe and smooth transition of services – so don’t expect anything to look different right away.

The crucial bit in this is the commitment from now onwards to build it all from the neighbourhood level. That means services, leadership, management, partnerships, the whole fabric of the LCO will be closer to the communities where people actually live. It’s a huge opportunity to ensure the voluntary organisations, charities, community groups and social enterprises can bring their expertise into supporting health, care and wellbeing. It also means that there will be more opportunities to involve local people directly in shaping services and building local solutions about what matters to them. Some of the things to enable that are being put in place. There has been investment in co-ordinator roles, community connector roles, care navigators. It’s a sign that the LCO is trying to find ways of connecting into the community.

There is a lot further to go on this: you don’t just need the mechanisms, you need the culture and collaboration. We are starting to see services such as GP practices reach out to the local voluntary organisations for support and to be involved in jointly designing new services. I would like to see more of this investment placed within the community sector as it has all so far ended up in the public sector organisations. There are good signs that this is starting to change with news that there will be Neighbourhood Budgets but these must keep pace with the expectations being placed on local groups as this new way of working accelerates. (Impressive, but you’re not a Jedi yet.)

The other thing which now becomes possible is the ability to focus. The LCO will be able, through collaborative leadership, to connect our fragmented systems. This means building a strong approach to information sharing – particularly user-owned records – and a focus on wellbeing looking at those factors that most influence health such as isolation and driving a strength-based approach through the delivery of all services. That’s the only way it is going to be possible to rebalance the priorities and the budget from hospital and into community-led preventative approaches.

For those involved in this work – in service delivery, in management and back offices - it means letting go of a lot of assumptions, learned behaviours, professional habits. It will mean challenging the rest of the system which is resistant to change. It will mean finding ways of collaboration bringing public services into all of this “community stuff” which surrounds everything and binds everything together (….yeah….the Force, you knew that was where this was going, didn’t you?) This is a new way of being for these institutions and the people inside them and it will also be new for the voluntary organisations too.

In that bit in Star Wars, Obi Wan shows Luke that he has to find a new way of being – not just a new idea, a new skill or a new technique, it’s an entire discipline. “Trust your feelings” he says. Obi Wan challenges Luke to let go of everything he thinks he knows. At the end of the scene Luke recognises that he has just had his first experience of his new self as a Jedi. That is what I hope the LCO is bold enough to do here by really embracing that commitment to neighbourhoods and community.

It will take a long time, mistakes will be made along the way, poor decisions will be made and there may be unnecessary amounts of time spent on writing strategies and models which aren’t ultimately needed. But all that effort is now pointing in the right direction: I remain hopeful this is the next major step in transforming the way health and care works in this city. From April, that future becomes more likely.

The Force will be with them.



P.S. One last insight: it is possible to overextend a metaphor.

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