Gaps and barriers

Please note; we are in the midst of a thorough re-construction of these pages. For the moment, there may be some duplication of material from elsewhere; and probably some broken links. Bear with us. Its a lot to cover......

Working in the cracks

Understandably, and probably rightly, we expect services to be focussed primarily on the things that they themselves do, and so can do something about. 

Yet the gaps between services, or the barriers to acceptance from other services, or simply overloaded and unavailable services for moving on, can restrict or distort the scope of working with their users' needs.

With the best will in the world, the most motivated staff and the most enlightened thinking, sometimes the constraints on services are simply not in the control of the service itself.

Nevertheless, dealing with these gaps and barriers then becomes a key part of the day-to-day work of the service; and how the service does respond is at least within its control.

Outreach services, however, are in a different position here. In the case of outreach services, negotiating gaps and barriers for individual (and potential) service users may often be the cornerstone of your offer. As a result, outreach workers, just as much as their clients, will have an acute awareness of where these obstacles lie.


Learning from working in the cracks

But how is this lived experience communicated and passed up through various chains of command and filters, to inform local commissioners and funders of what needs to change?

In the case of those areas that have experimented with system brokerage (HERE), there was at least the intention to fast-track this communication, usually with a small and selected sample of those with the most complex problems, who are taken to be indicative of the whole.

It is for this reason that the PIEs 2.0 model explicitly refers to co-working with other agencies - 'sector engagement' - over the needs of individuals as an issue for psychologically informed services (HERE). The very fact that we are dealing with complex needs in itself suggests the need for consultation with and/or co-ordination of the efforts of multiple more specialist services, to meet the needs of individuals.

It is for this reason too that the PIEs 2.0 made a place for services that are engaging pro-actively with the whole system, particularly at locality level, where gaps and barriers exist, to use your knowledge of the user to feedback to those responsible for the whole, who negotiate contracts with other services (HERE).

So important is this issue for services that the Pizazz assessment framework - both the Pizazz on paper, and the on-line version, the PIE Abacus - specifically encourages those assessing a service to identify where there are hindrances to the service's work that are outside their control, to flag this up both to management and to local funders.  The guidance is explicit that a low score in some areas, such as this, should NOT be seen as a weakness of the service, but as an indicator of what holds them back.


Mindsets; another kind of barrier

Gaps and barriers are not the only hindrance, however. In recent years we have seen more critical voices challenging the whole framework of commissioning, funding and evaluating services.  An ill-considered narrowing of contracts and outcome measures, or overly-restrictive, micro-managing service specification can also tie the hands of a service and severely curtail its capacity to be responsive to the needs of service users.

We are also seeing even more sweeping critiques of the mindset that has predominated in services delivery in recent years. The challenges of Human Learning Systems and Enabling Help question the drivers behind the whole framework of public services provision, replacing contracts and performance indicators with dialogue and partnership, and system change. (HERE)

Background, reading & other links

PIElink pages

Whole systems as PIEs ; HERE

A PIE of pathways : HERE

Gaps and Barriers : HERE

Rigidity and system change: HERE

A single framework : HERE

Spaces of opportunity 101 : HERE

Can commissioning help to encourage PIEs? : HERE


A selection of like-minded agencies & colleagues

Beyond Outcomes (Enabling Help) :  HERE

The New System Alliance : HERE

Human Learning Systems : HERE

Fulfilling Lives : HERE

Collaborate CIC : HERE

Lankelly Chase : HERE


Johnson R: Do 'complex needs' need 'complex needs services'? (Part One)

Johnson R: Do 'complex needs' need 'complex needs services'? (Part Two)

Johnson R (undated) Key learning from history of the CPA in mental health as a lead professional model for complex needs HERE

Service users' PIE assessments (page) HERE

Lankelly Chase: Behaving like a system HERE

Zaxk Ahmed on Participatory appraisal in Tower Hamlets HERE

Lipsky on street level bureaucrats HERE