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Wednesday, 23 March 2016 06:43

Local Area Coordination: the new front door for care and health

Written by Alex Fox
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Local Area Coordinators work in a small neighbourhood and have an open door for individuals and families at risk of developing greater support needs. They have the time and space to get to know people and help them identify what a good life looks like to them and how best to achieve it. LACs don’t just look at a person or family’s needs, but also at their capabilities and potential. Their goal is to help people to find practical ways of doing the things they want or need to do, developing and using supportive relationships and being part of community life. Where community connections or activities aren’t available, the LAC has a community development role, as well as helping formal services to reach those who most need them and to shape support around people’s capabilities.
So where an older person who is struggling to live well and independently, has become isolated and reluctant to accept formal help, the LAC approach would be help that individual identify the things they want to change, build connections with those around them and think about the contribution they want to make to their community. One older person who was isolated, in decreasing health and struggling to maintain a safe home, turned out to have been a keen angler. The LAC didn’t look for a befriender to take him fishing, but someone who wanted to learn to fish. Making that connection and contributing to someone as their teacher, was the key to that individual taking control of many other aspects of their life and avoiding the path to hospital or residential care.

This week I chaired Capita and the LAC Network’s national LAC conference hosted by Capita Conferences. We heard strong support for LAC from NHS England, local areas including the Isle of Wight vanguard and Derby, and we heard from LAC founder Eddie Bartnik. Here are my opening remarks:

Services which aim to prevent people developing significant support needs have always wrestled with a paradox, often without realising it. The paradox is that the act of offering support can in itself reduce, rather than help build, an individual’s resilience.

Too many information and advice services are a collection of signposts into service land. Many interventions begin with assessment of need. But often, the more accurately and comprehensively we define a person’s needs, the less we can know of their capabilities, strengths and potential.

Often the very processes we use to help people stay or return to independence become the funnels into our service pipelines. This is particularly stark in hospital discharge processes, where a detailed picture can be built of an older person’s fragility post-operation, but nothing may be known of the independence they were achieving only a few days before. The longer the risks are assessed, the more muscle strength that older person loses to their hospital bed, until the risk assessment becomes a self-fulfilling prophecy of service need.

Keeping the faith in prevention is hard at the best of times, and these are not the best of times. It is even harder when it’s unclear whether problems and greater support needs are genuinely being prevented.

We are here today because Local Area Coordination has demonstrated that it is possible to intervene early in a way which helps individuals stay strong and connected. Which builds resilience and confidence. This is not just a new intervention to resource in an already-stretched system. It can be the key to reforming the whole system around the capabilities of individuals, families and communities. Systems which start with LAC are more likely to build in asset-based approaches like peer-support, time banking, community enterprise, Shared Lives and Homeshare further down the road, because they will be the natural fit for the goals people identify.

LAC has a long history in Western Australia from which a growing number of areas are drawing in the UK. This conference comes as some of those areas are coming together to build the new national LAC Network, so let’s think about what kind of national network we need to develop LAC in the UK, but given this is all about an asset-based approach, mainly what you and I are willing to contribute to it.


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