The Thomas Coram Foundation – A Highly Commended Health Service Case Study

Here is another in our series of reports covering entries from the recent GO Excellence in Public Procurement Awards. The entries are chosen from categories for which Peter Smith was a judge, so they were studied very carefully, and each one is featured based on how interesting we felt it would be for our readers, rather than on whether it won the award.

Thomas Coram created the first Foundling Hospital 275 years ago in London for children whose mothers could not look after them, and in doing so created what is now one of the oldest children's charities in the world. That focus on young people who need help has continued, with Coram (as they are known these days) involved in various activities, through education and adoption advice to the work that led to their participation and receipt of a "highly commended" in the recent GO Awards.

Coram's work with Kent County Council started with advice on adoption services, based on their long experience in that area, but became something much more extensive. Coram started to manage the Adoption Service for Kent County Council in March 2012. The contract was initially for two years but has since been renewed twice, and will now end in January 2016. Coram staff work alongside Kent staff to deliver the adoption service -- the first arrangement of its kind in the country. Coram uses a problem solving approach, placing the child at the heart of everything they do, meaning "operational work informs strategy development."

The programme has used both Coram's understanding of the whole adoption process, as well as more general business skills: re-engineering the processes around adoption to increase effectiveness and drive better outcomes.

We spoke to Kevin Yong, Coram's Head of Consultancy, at the recent awards evening. What made the organisation decide to enter the awards?

"We thought ours was a very different and innovative approach, one that we had not seen done anywhere else. Often this kind of improvement project is undertaken from a management consultancy-led basis, but our method was very much practice-led and hands-on, embedding ourselves within the organisation and using our experience and expertise in dealing with looked-after children."

What did the Kent commissioners and procurement people get right here in terms of a very strategic supplier's viewpoint? we asked.

"The key thing was the support we were given right from the top. It was very important to have full backing from the elected members and commissioners. It was their ‘proactiveness’ that made a real difference, with involvement from the councillors, not just the executives. They gave us free range to action as we saw fit, with their support. So, although we went in as an improvement team, we realised we would have better impact if we were working inside the team. We had full cooperation from the head of service and other staff. We used performance management as our starting place and used data analysis to help make the right, evidence-backed decisions. It was a very analytical process, and the data also allowed the authority to contract manage us.”

What about the results - can you quantify those?

“We are most proud of how we turned around the culture of the service and increased the number of placements. In this kind of sector, it is not just the process effectiveness that is important, it is the improvement in quality of lives – and that is much harder to measure.”

And as the award entry states:

"The partnership has achieved an increase in the number of children adopted per year - from 70 in 2011/12 to 145 in 2013/14, and an increase in the number of children placed per year - from 68 in 2011/12 to 170 in 2013/14. In fact, the figures for 2013/14 were the highest of all local authorities in England. Children with plans for adoption are now spending an average of three months less in care, meaning they have improved chances of having better outcomes in their life as adopted children. This has also resulted in at least £500,000 in avoided expenditure for Kent in the first two years of the partnership."

That is impressive, with both those hard savings and the long-term human benefits of getting looked-after children out of the institutional care system into (hopefully) stable long-term home environments. Well done to Kent and Coram, and surely an initiative that other councils should be looking at and learning from.

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