Common Ambition and Fulfilling Lives South East- a flourishing partnership

In this blog we reflect on a productive partnership that has helped nurture systems change. We look at what elements most contributed to this relationship and the role coproduction can play in catalysing change.


Common Ambition and Fulfilling Lives South East (FLSE)

The Brighton and Hove Common Ambition project works with people who have lived experience of homelessness, frontline providers and commissioners in order to improve health services and outcomes for people experiencing homelessness in Brighton & Hove. This is done through co-production. Common Ambition is funded by Health Foundation and is run in partnership between ARCH Healthcare, Justlife, University of Brighton, Brighton and Hove CCG and Brighton and Hove City Council Public Health Department. Funding was secured in 2021 and the project is guided by a passionate steering group of experts by experience.

The FLSE project, based at BHT Sussex, is one of 12 partnerships funded by the National Lottery Community Fund to provide intensive support for people experiencing multiple and complex needs, involve people with lived experience at all levels and challenge and change systems that negatively affect people facing MCN. While this eight-year project will soon be coming to an end, we recognised the potential of collaborating with Common Ambition.

At FLSE, we were keen to collaborate with the Common Ambition team from the start; we saw a real opportunity to share our learning while amplifying our voices to champion for changes in healthcare services and systems to improve outcomes for people experiencing homelessness.


What we did together

Ever since early 2021, monthly catch ups between staff members helped facilitate a collaborative approach, providing a regular space for exchange. Nicky Pyper, Project Manager of Common Ambition, says ‘The support Fulfilling Lives has given Common Ambition since the very beginning of the project has been invaluable. Always on hand to discuss arising issues, share learnings and make connections, we would not be where we are now without them. The monthly catch ups have been really useful as a place to share best practice, look at how we can work together and ask for advice. Then knowing the team were always willing to share their knowledge or could point us in the right direction for help when we were designing the project, bringing our lived experience groups together and then carrying out research was such a support to the project.’

We invited Common Ambition to internal Project Group meetings about promoting changes to address health inequalities, shared our reports and blogs and invited the Common Ambition team to our Action Group to get first-hand accounts of service experiences from FLSE volunteers with lived experience.

Both FLSE and Common Ambition teams share a commitment to co-production and this was an important part of our partnership work. FLSE has worked for eight years to test lots of ways to bring co-production to life and have learnt useful ways to align co-production and systems change efforts. We wanted to share the FLSE approach and learning of facilitating co-production in practical systems’ change projects to support the Common Ambition team shape and set up their co-production approaches.

Co-producing with partners and people with lived experience weaves authenticity and integrity into the fabric of systems change.  It makes sense to involve the people who will be using services in their design, delivery, and evaluation, and to work closely with those who know them best to ensure a safe, accessible working environment.  Furthermore, the professional relationship that develops as a result of inclusive, equitable collaboration is different in quality to one that does not prioritise these approaches.  When all invested parties work together towards a common goal, without rivalry or a defensive position, the partnership becomes supportive in nature; with the attitude that we are helping each other to achieve a common goal.  This mutual trust is the foundation for a respectful, strong, supportive, and effective partnership.

Sharing learning – a deeper dive

One of the highlights of this collaboration was FLSE’s Service User Engagement team creating and facilitating custom-made training sessions for Common Ambition’s Steering Group members. The sessions focussed on topics such as confidentiality, professional boundaries, mutual respect, effective communication, active listening as well as what real co-production looks like in practice and how it is different from other forms of engagement.
 
Our team adopted a trauma-informed lens while co-designing the sessions. Prior to the training, our team visited a steering group meeting to familiarise themselves with the members of the group and find out what their expectations and asks were for the content of the sessions – what and what not to include. Then, we invited the staff from the Project to review and feedback on the training to account for any sensitivities or requirements and ensure that we enhanced the group’s ongoing learning. This was a successful strategy because it allowed us to build an open and trusting relationship from the very beginning and develop a sense of psychological safety for the group members. This was also reflected in the feedback we received from the participants, with all of them giving us a 10/10 score to the question whether they would recommend us to a friend or colleague.

For us, these are the three tips to consider when facilitating workshops for service user groups:

  1. Get to know your audience and use a trauma-informed approach based on principles of safety, trust and transparency, choice, collaboration, and voice.
  2. Address barriers to inclusion which can be thought of in terms of making language accessible, accounting for any mobility/disability issues for example.
  3. The topic you present on may be entirely new to your group, so be prepared to tailor your session and change tack if any tricky situations arise.

Nicky Pyper commented about the training that “We can’t thank the Fulfilling Lives team enough for the fantastic training you delivered. It was exactly what the group wanted and was thoroughly sensitive to the group’s needs throughout. It was the perfect mix of presenting, group work, activities and discussion. The group all commented on how great the trainers were, in particular noting their down to earth and caring approach. It didn’t feel like we were in a classroom setting, rather that the whole group was going on the journey together. Group members commented that they felt like they learnt a lot. We will be building on the work Fulfilling Lives did with us and making sure we revisit our learnings regularly.

Looking to the future

As FLSE is now reaching the final stage of the project, we are proud to know that Common Ambition will continue influencing the system to make primary healthcare more accessible to and impactful for people experiencing multiple and complex needs.

Michaela Rossmann from the FLSE team reflected that “being open and proactive in partnerships is key when trying to influence systems. For me, sharing learning and supporting each other, finding commonalities and focussing on the positives are what makes the partnership with Common Ambition so unique. It’s built on trust, mutual respect and understanding. Common Ambition has been an ally for FLSE from the start and it’s been great to see the project go from strength to strength.”

Nicky Pyper reflected that “Common Ambition will carry on the FLSE legacy of putting the voice of those with lived experience at the heart of system and service change and will continue to advocate for co-production. We will also be continuing to shine a light on ‘Bright Spots’ and raising awareness around the challenges people experiencing MCN face when accessing and using healthcare services. Areas that our lived experience groups have found particularly interesting are the implementation of frailty scores for people experiencing MCN and treatment in A&E, we hope to continue to explore this.”

For more information about FLSE’s systems change work to address health inequalities please read our Ripple Effect impact report

For more information about the Common Ambition project, please visit their website


Authors:

Michaela Rossmann, Systems Change Officer:

Aditi Bhonagiri, Engagement and Co-production Worker

Ian Harrison, Engagement and Co-production Worker

Rebecca Rieley, System Change Lead

For further information about Fulfilling Lives work in this area, please contact:

rebecca.rieley@sefulfillinglives.org.uk

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Employing People with Lived Experience of Multiple and Complex Needs

We would like the knowledge our toolkit contains to travel far and wide, making its way into the hearts and minds of organisations across the country, and for employers to recognise the benefits of employing people who have been through hardship and continue to fight for themselves.


A toolkit for employers

Fulfilling Lives South East (FLSE) has been running for eight years.  Eight years is a long time.  Over the course of the project, a lot has changed.  We have tried, tested, adapted, won some, and lost some.  Through all this experimentation, we have learnt a lot about the ‘system’, and a lot about people.  As the project draws to a close, we want to share what we have learned along the way

A major feature of the FLSE project was its employment program, the purpose of which was to employ people with lived experience of multiple and complex needs (MCN) and support them through their recovery from a work-centred perspective.  Those employed were titled Project consultants (PC) and attached to the Service User Involvement (SUI) team.  Their lived experiences varied in combinations and intensities across the spectrums of substance misuse, mental health, repeat offending and homelessness, while their duties were similar, their skillsets differed.  Those occupying the role came from a variety of backgrounds, including but not limited to design, research, psychology, biological sciences. They were also tasked with mentoring lived experience volunteers whose experiences ranged from students to city workers.

In the eight years, the project has seen many lived experience team members come and go.  The majority successfully moved on to other employment, either directly from FLSE, or within six months of leaving the project, while others were not quite at the right stage of their recovery to complete their contract.  Throughout this time, the managers and supervisors have evolved their support practices as they’ve learned what helps (and what doesn’t help) staff with experiences of MCN.  More than that, they’ve helped those staff members to harness their own skills to drive systems change forward. 

Inclusive, supportive workplaces for all

In 2021, we decided to develop a toolkit aimed at employers to consolidate what we have learned about employing people with experience of MCN.  The more we discussed the idea, the larger in scope it became.  In essence, it is a guide to help organisations foster a culture where lived experience of MCN is not only supported but valued.  It’s about creating an inclusive, supportive workplace culture that benefits employers and employees, regardless of whether they have experience of MCN or are just going through a difficult time.  Our toolkit exists to support organisations in creating that culture by providing tools, approaches and practices that help them to help their employees thrive and be successful so that they, in turn, can give their best in their working roles.

So, what does that support look like?  Having seen 41 Project consultants pass through FLSE, all with different life experience, we have a wealth of knowledge to share.  Our toolkit distils down to the overarching support themes that – although written for people with lived experience of MCN – can be applied to all employees.  Its foundation is three principles: Psychologically Informed Environments, Co-production, and Trauma-informed Practice.  Together, these concepts underpin the way people work together, how they treat each other, and how the working environment respects and reflects the (sometimes) difficult life experiences of its employees.  On the surface, they are simple to understand, but require consideration when put into practice.  It is a culture-change, so that means staff need to be on board at all levels, and it takes time and diligence to overwrite old habits, thought processes, and ways of relating.  These three principles should be applied throughout the recruitment process, supervisions, and day-to-day working practice. 

The toolkit also highlights the benefits that people with these life experiences can bring to organisations and the people working within them.  The chances are high that there are multiple people in any organisation who have personal experience or know someone close to them who has experienced addiction, mental ill-health, offending behaviour, or has either been homeless or close to being homeless.  Having someone relate to these circumstances can help with feelings of isolation and shame.  This alone can build stronger, more trusting relationships, while reducing stigma and improving wellbeing within organisations and teams.

The British Medical Association reported in their July 2016 publication (that alcohol use is prevalent among those who work, more so than those who are unemployed, and that it is a growing concern for employers.  The Office for National Statistics reported on their website that in the UK in 2020, 11.6% of absences from work were due to mental ill-health.  Criminal behaviour is not uncommon in wider society.  Violence and substance use are daily occurrences.  These intertwined issues are not confined to people with MCN histories; they apply to people from all walks of life in any profession.  Although our toolkit is designed for supporting people who have combinations of adverse experiences, it can be just as useful for people who are struggling for a single reason.  

Sharing our knowledge

We would like the knowledge it contains to travel far and wide, making its way into the hearts and minds of organisations across the country, and for employers to recognise the benefits of employing people who have been through hardship and continue to fight for themselves.

If you are an employer and would like to discuss this further or have some support around employing people with lived experience of MCN and how to do it well, then please get in touch at the contact email below by 1st June 2022. We’d be more than happy to help!


Author:

Ian Harrison, Engagement and Co-production Worker

For further information about Fulfilling Lives work in this area, please contact:

Andree Ralph, Co-production and Engagement Lead:

andree.ralph@sefulfillinglives.org.uk  

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