London Borough of Tower Hamlets application case study
Outreach work is at the heart of LinkAge Plus (LA+). Based at the five Network Centres as well as premises of partner organisations, the twelve LA+ Outreach Workers make connections across sectoral, institutional and service boundaries to support small groups and individuals, and to increase the provision of services.
There are a large number of sheltered housing schemes in Tower Hamlets. While many have the facilities for classes and group activity, few have the resources and expertise to identify appropriate classes and activities, engage providers, and help with finding tutors and funding for classes. LA+ Outreach Workers provide this support to third sector providers, and operate as facilitators rather than providers of new and additional services. By increasing the capacity of staff working in other organisations, such as sheltered housing schemes, LA+ contributes to a wider and better provision of services:
A Resident Scheme Manager said:
"The Outreach Workers have made a real difference to my scheme, definitely. The residents wouldn't do nothing, I mean nothing. I would try my hardest to do meals or bingo and they were never interested. But since the Outreach Worker has been coming over once a week, having outside people coming in, makes them want to join in, because they see me everyday."
Identifying and reaching isolated older people can be one of the most challenging tasks for LA+ Outreach Workers. Drawing on volunteers who 'keep an eye out' for lonely people, talking to service users as they attend activities, and using other informal networks has helped address this. Such networks tend to be personal to individual Outreach Workers and initially it was volunteer based organisations which were able to draw in large numbers of isolated older people.
LA+ Outreach Workers have made over 10,000 outreach contacts between October 2006 and April 2008, connecting isolated older people to services, information, and social interactions. They play a critically important role in helping older people access resource centres to participate in activities, but also in drawing in professional carers to deal with problems. Their engagement of older people is diverse covering befriending and needs assessment, referral to public sector providers and encouraging social activity:
An Outreach Worker said:
"I've got one lady that's been calling the doctor quite a lot because she is in a state of depression. Her family has just moved away and she's thinking 'oh, what's going to happen to me?'. Somebody told me about her and I've been round quite a few times, about twice a week to, you know, gradually draw her out, stop her phoning the doctors, stop her calling the emergency services. She just feels alone and isolated all of a sudden. So I'm hoping in another couple of weeks she'll come out on one of my shopping trips and start to take part other activities here at the centre."
A service user commented:
"It got me my eyesight back really. ... The Outreach Worker met the nurse and she came and talked to me. I was surprised because they'd finished with me at the London Hospital, couldn't do no more for me you know. I was so surprised when I got a letter to say, like, you go up and they'd give you this treatment. To me it's been a miracle because ... I could hardly see. And it's really only through LinkAge that that's happened to me."
Outreach work is not just about reaching individuals, its also about supporting the large number of small groups which cater for highly localised needs, and which tend to work in isolation from other groups, depending primarily on volunteers to organise activities, and small grants to fund classes. LA+ has actively sought to identify such groups, and support their work through technical or small financial contributions towards activities.
Equally important is guidance on where to find resources and how to access them. The capacity of many groups is also built by connecting them with the LA+ network which provides information and access to resources. Thus Network Centres fulfil a capacity building function for third sector groups and small organisations, and by doing so deliberately multiply the resources and services that are available to older people.
Furthermore, the LA+ approach reduced duplication in provision through better coordination and also has reduced competition for resources amongst smaller providers.
Another Outreach Worker said:
"You won't just find them, you have to go out and look for them. You literally have to walk around and look for them, and we just keep finding these little groups."
A service user said:
"We wouldn't be where we are today and we wouldn't have the group that we have today without LinkAge. They gave us the knowledge to start it up."
LA+ Outreach Workers are critical to the success of LA+ in connecting older people with services, of better utilising existing services and of building the capacity of small as well as large third sector organisations to provide better services. Their flexibility in working across different service areas, in being able to draw on informal as well as formal networks, which include volunteers, is filling a significant gap in current statutory service provision in the borough.
The joint commissioning approach taken by the council and PCT towards the mainstreaming of LA+ is evidence that outreach work is recognised as making statutory and third sector providers more effective in providing services for older people.