Social care and health services have reached a point of possibilities and choices – either to focus on a continual tinkering and adapting of existing or new services, or to re balance with a greater emphasis on individual, family and community strengths, self sufficiency and mutual support alongside more personal, flexible, reformed services.

If the emphasis continues to be too heavily based on a new generation of expensive service led responses, it will probably be an opportunity missed.

If we start to think about the possibilities from the inherent and plentiful assets, capacity and contribution of individuals, families and communities, in partnership with valued, personal and focused services, we have the opportunity for real and sustainable change.

Local Area Coordination (LAC) is a “strength based” approach, originally developed in Western Australia more than 20 years ago, now developing across England and contributing to thinking around building individual, family and community capacity, prevention, strengthening communities and nurturing more welcoming, inclusive and mutually supportive communities.

It moves the “primary source of support” or “front end” of the service system from crisis, assessment and services to prevention, capacity building and local solutions.

It also gives the space and context to re think the expectations of services and professional roles as a valued, personal, flexible back up to local solutions.

“So, Local Area Coordination starts in the right place – the start – it does not wait for problems to grow too big, it does not encourage dependency on service-solutions. It begins by helping people to be as strong and as connected as soon as possible – preventing problems and crises.

This is not just a structural change, it is also the practical application of a powerful set of values. LAC is rooted in a tradition that does not see people as fundamentally needy. Instead it starts with the assumption that people have gifts and the right to shape and control their own life and the expression of those gifts in community. This means putting each person at the centre of decision-making and working with the individual and family to pursue their vision for a good life as part of their community” (Broad, 2012)

Below is an extract from “Local Area Coordination – From Service Users to Citizens” – out now via Centre for Welfare Reform http://www.centreforwelfarereform.org/library/by-date/local-area-coordination.html

1.             Starting at the start

Local Area Coordination is a systematic effort, organised and led by public bodies in partnership with local people and communities, to ensure that people can prevent their ordinary needs from becoming major problems, avoid crises and support themselves to maintain and strengthen their everyday citizenship.

The Local Area Coordinator supports 50-65 individuals and their families who live in a defined local area. They provide a local, accessible and single point of contact for people of all ages who may be vulnerable due to age, disability or mental illness.

They are the “front end” of the service system. They work by helping people to identify their own vision for a good life and ways to achieve it.

Local Area Coordination is an approach that recognises and supports the value of individual gifts, skills and assets, the powerful and positive role of families and relationships and the contribution that local communities can make as alternatives to professional health and social care services.

It provides a foundation for helping people to stay strong and to be as valued members of their local community.

Local Area Coordination turns the existing system on its head and drives positive cultural change across the whole system; for it puts a greater emphasis on:

• Recognising the gifts, assets and contributions of local people
• Building stronger and more inclusive communities
• Promoting citizen and family leadership
• Working with communities to support inclusion and mutual contribution
• Planning for the future, staying resilient and well-connected
• Supporting people to achieve their fundamental aspirations

This is a fundamental change in both organisation and values. It is based on carefully developed models and practices. It is not achieved by simple renaming existing systems or by organisational restructuring.

A new and focused role

Local Area Coordination is an innovative approach that integrates a range of existing roles (usually provided by a range of different people) and delivers them locally in partnership with local people and communities.

Too often the current system (see Figure 1):

1. leaves people in isolation as problems grow

2. only reacts when there is a crisis

3. waits until people’s needs climb above the eligibility threshold

4. segregates people within services, cut-off from their community

This system drives up costs and reduces the chances of good solutions that build citizenship and stronger communities.

Local Area Coordination reverses the standard pattern of delayed response. Instead, the Local Area Coordinator focuses on developing a trusting, ongoing relationship with local people (person by person) and with their community. They work pro-actively to support people to stay strong and support the development of possibilities and solutions that don’t require professional services.

Building on a real relationship and a real presence within the local community the Local Area Coordinator will:

1. help people identify their strengths and capacities to solve their own problems

2. provide practical assistance to ensure crises are overcome or avoided

3. help ensure people achieve their legitimate entitlements

4. support people to maximise their contribution as citizens

Eddie Bartnik, who originally developed Local Area Coordination in Western Australia, described it as an approach that “turns the traditional system on its head and changes the power balance. Rather than fitting people into a predetermined menu of services, support is built one person at a time, in the context of their family, friends and community. The focus is on choice and control for individuals in decision making” (Bartnik, 2008).

To read the rest of the paper “Local Area Coordination – From Service Users to Citizens” go to http://www.centreforwelfarereform.org/library/by-date/local-area-coordination.html

Also, to see Guardian Newspaper article http://www.guardian.co.uk/public-leaders-network/blog/2012/jun/19/local-area-coordination-social-care?INTCMP=SRCH

A big welcome to Julia Horsfall (Stroud, Gloucestershire) and Rajeev Nath (Derby City), new Local Area Coordinators – welcome to the LAC family.

A big responsibility, but also a wonderful, unique opportunity to make a real difference alongside local people in our communities

We look forward to hearing and sharing stories, exploring ideas that strengthen our local citizens and communities and sharing passion for nurturing the strengths, interests and mutual support of all citizens, including those who may be vulnerable due to disability, mental health needs, age or frailty

Welcome and best wishes for the future

27th June 2012 A Day in the Life of a Local Area Coordinator

A big thank you to Fiona Taylor for contributing to a great learning opportunity in Derby City – reflecting on the role, expectations, opportunities and passions of being a Local Area Coordinator (LAC).

We reflected not only on what a LAC does (person by person), the importance of the focus being nurturing individual control (not doing “to or for”), the value of individual, family and community assets as ways of building and pursuing a personal vision for a good life – but also that we are privileged to be allowed to be part of people’s lives and must always respect that privilege.

Fiona was a Local Area Coordinator in Western Australia for many years and we greatly appreciate her support, enthusiasm, passion and stories – looking forward to more in the future

20th June 2012 Article on Local Area Coordination in Guardian Newspaper

There is a new article on Local Area Coordination by Simon Duffy (Director Centre for Welfare Reform – http://www.centreforwelfarereform.org”>http://www.centreforwelfarereform.org) in the Guardian Newspaper today (20th June 2012) – http://www.guardian.co.uk/public-leaders-network/blog/2012/jun/19/local-area-coordination-social-care?INTCMP=SRCH”>http://www.guardian.co.uk/public-leaders-network/blog/2012/jun/19/local-area-coordination-social-care?INTCMP=SRCH

There is growing awareness of the need for a rethinking of the role of social care and health services and the central role that LAC and Asset Based approaches can play in helping people to stay strong, building more welcoming, inclusive and mutually supportive communities, recognising, nurturing and releasing community assets and energy and (crucially) contributing to the reform, integration and simplification of services and systems people.

These are discussions that we can hopefully share, working together to develop supportive, connected and positive communities of practice.

We currently have a real opportunity for positive change – let’s hope we can make the most of it!

I look forward to our future discussions, plans and actions together.

Keep the stories coming in

Best wishes

Ralph

19th June 2012 Local Area Coordination and Asset Based Community Development (ABCD) in Derby City

Great session with Cormac Russell, exploring LAC and ABCD in Derby City, as part of planned LAC learning events locally.

For more information about LAC and ABCD, see http://localareacoordination.wordpress.com/

14th June 2012 - New Report Published: Local Area Coordination – From Service Users to Citizens

The new paper on Local Area Coordination – From Service Users to Citizens” has been published by the Centre for Welfare Reform this morning.

It is available from the Centre for Welfare Reform website via http://www.centreforwelfarereform.org/library/by-date/local-area-coordination.html”>http://www.centreforwelfarereform.org/library/by-date/local-area-coordination.html

I hope it is useful in continuing the new conversations and development of LAC and reform – supporting people to build and pursue their vision for a good life, nurturing more welcoming, inclusive and mutually supportive communities and contributing to reform of social care and health services.

Hopefully it will also stimulate more discussions, partnerships and opportunities for us all to share ideas and learning.

A big thank you to Simon Duffy (Centre for Welfare Reform), Alex Fox (Shared Lives Plus), Brian Frisby (Derby City), Patrick Graham (Gloucestershire), Carol Taylor (Middlesbrough) and Neil Woodhead (Derby City) for their support and contribution to the paper and also for their commitment and passion for LAC and citizen led reform.

Our next step is to continue the conversations, share learning and new stories, as well as helping others to join us and start the positive reform process.

If you are interested in learning more about LAC or in being one of the next “learning and development sites”, please don’t hesitate to contact me.

Best wishes

Ralph

The full report is available via http://www.centreforwelfarereform.org/library/by-date/local-area-coordination.html

Originally developed in Western Australia, Local Area Coordination (LAC) has subsequently developed nationally and internationally, most recently starting in sites in England.

It is now contributing to thinking nationally around the value of individual and community assets, building community capacity, real personalisation (it’s about more than money) and making services more personal, local, flexible and accountable

It moves the “primary source of support” or “front end” of the service system from crisis, assessment and services to prevention, capacity building and local solutions.

Below is an extract from “Local Area Coordination – From Service Users to Citizens” (Broad, 2012)

Introduction

Local Area Coordination (LAC) was originally developed in Western Australia in 1988 to “build individual, family and community self-sufficiency so that individuals with intellectual disability can choose to live with their families, or in their local community without compromising their quality of life”.

In practice this means embedding a Local Area Coordinator within a small geographical community to support 50-65 individuals and their families. The Local Area Coordinator offers a single point of contact and helps people solve their own problems and build a good life as a member of their own community.

In other words Local Area Coordination starts in the right place – the start – it does not wait for problems to grow too big, it does not encourage dependency on service-solutions. It begins by helping people to be as strong and as connected as soon as possible – preventing problems and crises.

This is not just a structural change, it is also the practical application of a powerful set of values. LAC is rooted in a tradition that does not see people as fundamentally needy. Instead it starts with the assumption that people have gifts and the right to shape and control their own life and the expression of those gifts in community. This means putting each person at the centre of decision-making and working with the individual and family to pursue their vision for a good life as part of their community.

Too often, services do not just undermine the individual’s autonomy they also fail to recognise the wealth of possibility that exists in local communities. Local Area Coordination is not just embedded in community it is one way of building stronger communities. It helps people recognise what is already present but helps develop new opportunities. Local Area Coordination builds on all that is best in social work and fits the aspiration of many services to build capacity.

As such, it should be critical to any reform of social care and health services. Putting strength-based, preventative and capacity building approaches at the front of the system should help to connect and to reshape human services, to make them more personal, flexible and efficient. This will have a powerful impact across the whole system.

In the following four chapters we will explore each of these four elements of Local Area Coordination:

1. Starting at the start – reversing the crisis-led pattern of the current system
2. Building on assets – helping people solve problems, their own way
3. Connecting to community – identifying solutions that can be created within community
4. Transforming the system – changing the whole service system around these positive values

We will then end by exploring some of the outcomes associated with Local Area
Coordination and offers some thoughts for those in England and Wales who are now
beginning to express interest in the idea.

VISION STATEMENT
Local Area Coordination is underpinned by positive values, principles and assumptions about local people and our local communities. This includes the Local Area Coordination Vision (Bartnik, 2008) that

“All people live in welcoming communities that provide friendship, mutual support, a “fair go” and opportunities for everyone, including people vulnerable due to age, disability or mental health needs and their families.”

Furthermore, the Local Area Coordination Charter aims to

“Develop partnerships with individuals and families as they build and pursue their goals and dreams for a good life, and with local communities to strengthen their capacity to include people vulnerable due to disability, age, mental health needs or sensory impairments as valued citizens”.

For the full paper is available from http://www.centreforwelfarereform.org/library/by-date/local-area-coordination.html

The paper on Local Area Coordination in England and Wales, “From Service Users to Citizens” (Broad, 2012), is soon to be published.

The paper explores the impact and opportunities arising from LAC forming the new “primary source of support” (as per Vision For Adult Social Care, DH, 2010) or new “Front End” of the service system, placing greater emphasis on local solutions, individual and community strengths and citizenship and less on deficit based assessment, funding and services.

Local Area Co-ordination (LAC) was originally developed in Western Australia in 1988 by Eddie Bartnik and the Disability Services Commission, with assumptions and beliefs around the inherent expertise and strengths of people, irrespective of service labels, to plan, control and contribute to their own lives and the well-being of their community.

It also acted as a catalyst for service and systems reform, making services more personal, flexible, accountable and efficient, nurturing practical, local solutions as the “primary source of support” and pushing services back a level.
It has subsequently been developed across Australia and internationally, including sites now developing in England and conversations underway in Wales as part of social care and health reform.
In England, it is also part of the Think Local Act Personal (TLAP) Building Community Capacity workstream.

LAC is underpinned by 10 core principles and values relating to

• The right to citizenship, responsibilities and opportunities
• The importance of valued relationships and personal networks
• The importance of access to relevant, timely and accessible information to inform decision making
• Recognising and nurturing individual, family and community gifts and assets
• Recognising the natural expertise and leadership people labelled as vulnerable and their families
• The right to plan, choose and control supports and resources
• The value and complementary nature of formal services as a back up to natural supports and practical solutions

It is supported by the LAC Framework which provides guidance, clarity and maintains integrity, focus and outcomes.
It has a substantial evidence base, with over 20 international studies plus many further international and local publications.

It’s about supporting people to build their vision for a good life and finding a range of ways of getting there – and becoming less dependent on services wherever possible.

It gives space to think about the role of services and specialist teams, in the context of LAC and strength based approaches at the front end, embedded in the community.

In England, Inclusive Neighbourhoods Ltd and the Local Area Coordination Network are leading and coordinating the design and development of Local Area Coordination in England and Wales.

Turning the System Upside Down – Reforming the “Front End”
LAC moves the “front end” of the service system
from
crisis/assessment/eligibility/services (for those who meet criteria), with resulting ever-increasing unmet need,
to
supporting people to stay strong, building long-term trusting relationships with local people and the community, local solutions, valuing and nurturing individual/family/community assets, supporting mutually supportive and inclusive communities.

It also contributes to wider reform and integration of the service system.

Local Area Coordination is already developing in Middlesbrough, Derby City, Stroud and Cumbria. Developments are due to start in East Midlands in August 2012 and conversations are underway in the SE, NW and in Wales

From Service Users to Citizens (Broad, 2012)
Below is an extract from Chapter 1 of the paper “From Service Users to Citizens” (Broad, 2012. p.17), exploring some of the core principles, approaches and opportunities of Local Area Coordination, including the value and abundance of individual and community assets, focusing on helping people to stay strong, rather than waiting for crises and reforming, simplifying and integrating the service system.

1. Starting at the start
Local Area Coordination is a systematic effort, organised and led by public bodies in partnership with local people and communities, to ensure that people can prevent their ordinary needs from becoming major problems, avoid crises and support themselves to maintain and strengthen their everyday citizenship.
The Local Area Coordinator supports 50-65 individuals and their families who live in a defined local area. They provide a local, accessible and single point of contact for people of all ages who may be vulnerable due to age, disability or mental illness. They are the “front end” of the service system. They work by helping people to identify their own vision for a good life and ways to achieve it.
Local Area Coordination is an approach that recognises and supports the value of individual gifts, skills and assets, the powerful and positive role of families and relationships and the contribution that local communities can make as alternatives to professional health and social care services.

It provides a foundation for helping people to stay strong and to be as valued members of their local community.

Local Area Coordination turns the existing system on its head and drives positive cultural change across the whole system; for it puts a greater emphasis on:
• Recognising the gifts, assets and contributions of local people
• Building stronger and more inclusive communities
• Promoting citizen and family leadership
• Working with communities to support inclusion and mutual contribution
• Planning for the future, staying resilient and well-connected
• Supporting people to achieve their fundamental aspirations
This is a fundamental change in both organisation and values. It is based on carefully developed models and practices. It is not achieved by simple renaming existing systems or by organisational restructuring.

A new and focused role
Local Area Coordination is an innovative approach that integrates a range of existing roles (usually provided by a range of different people) and delivers them locally in partnership with local people and communities.

Too often the current system:
1. leaves people in isolation as problems grow
2. only reacts when there is a crisis
3. waits until people’s needs climb above the eligibility threshold
4. segregates people within services, cut-off from their community
This system drives up costs and reduces the chances of good solutions that build citizenship and stronger communities.

Local Area Coordination reverses the standard pattern of delayed response. Instead, the Local Area Coordinator focuses on developing a trusting, ongoing relationship with local people (person by person) and with their community. They work pro-actively to support people to stay strong and support the development of solutions that don’t require professional services.

Building on a real relationship and a real presence within the local community the Local Area Coordinator will:
1. help people identify their strengths and capacities to solve their own problems
2. provide practical assistance to ensure crises are overcome or avoided
3. help ensure people achieve their legitimate entitlements
4. support people to maximise their contribution as citizens

Eddie Bartnik, who originally developed Local Area Coordination in Western Australia, described it as an approach that “turns the traditional system on its head and changes the power balance. Rather than fitting people into a predetermined menu of services, support is built one person at a time, in the context of their family, friends and community. The focus is on choice and control for individuals in decision making” (Bartnik, 2008).

“From Service Users to Citizens” will be out soon – watch this space!

For more information about Local Area Coordination (LAC), or if you are interested in being involved as a “learning site” for Local Area Coordination and Asset Based Community Development (ABCD), contact Ralph at Inclusive Neighbourhoods Ltd (ralph@inclusiveneighbourhoods.co.uk or 07927056164) or Cormac Russell, Director of Nurture development and the ABCD Institute (Cormac@nurturedevelopment.ie ).

See Ralph and Cormac’s TLAP blog
Tinker or Reform? The Choice for Social Care and Health Services. http://www.thinklocalactpersonal.org.uk/Blog/ReformingServices/
For full paper see – http://localareacoordination.wordpress.com/

Tinker or Reform? The Choice for Social Care and Health Services

Ralph Broad (Director Inclusive Neighbourhoods) and Cormac Russell (Director Nurture Development)

We are now at the crossroads in social care and health services and also in our local communities.           A “crossroad” presents us with a set of questions. Here are some of the interrelated questions that are exercising us

1.  Is Personalisation dead?
2. Can Personalisation and Personal Budgets solve all our social care problems?
3. Do we continue to just cut services and tighten eligibility, risking increasing crises, dependency, unmet need and exclusion in our local communities?
4. Do we further complicate the system by just adding new, often disconnected, service initiatives but keep the system and balance of power the same?
5. Do we continue to tinker with existing professional roles, adding in new responsibilities and often making the roles (and service system) more complicated, less focused, less satisfying (for professionals involved) and moving them away from their original principles and vision?

We believe the answer to each is “no”

Having answered accordingly, some high level solutions present even before we go down one pathway or another:

1. Don’t wait for people to fall into crisis
2. Don’t judge or label local people and local communities on perceived deficits
3. Work together to recognise and nurture their gifts, skills, passion and aspirations
4. Support people to develop their own personal vision for a good life and the range of ways they can get there.
5. Maximise the effectiveness and value of specialist services as a back up to local, practical (non service) solutions and connect people who need resources or services more quickly and simply

Over many years, the health and social care system in Britain has become very fragmented and difficult to navigate (for both people/families and professionals) and has focused predominantly on deficits of local people, defining people by what they can’t do, and applying services or money for solutions to those deficits. This has created a dependency culture, with people viewed as “clients”, “service users” or “customers” of a social care system and often negatively labelled as passive recipients of social care funding or services; and accordingly viewing themselves as supplicant.

Local Area Coordination (LAC) and Asset Based Community Development (ABCD) are two approaches developing in the UK aimed at paving a clear path for citizens and policy makers away from “clientelism” and towards active citizenship. In practice, both approaches aim to nurture individual, family and community strengths to build stronger, more welcoming and more inclusive communities and, in a broader ideological sense, supporting the re imagining of social care and health services

Local Area Co-ordination (LAC) was originally developed in Western Australia in 1988 by Eddie Bartnik and the Disability Services Commission, with assumptions and beliefs around the inherent expertise and strengths of people, irrespective of service labels, to plan, control and contribute to their own lives and the well being of their community. It also acted as a catalyst for service and systems reform, making services more personal, flexible, accountable and efficient, nurturing practical, local solutions as the “primary source of support” and pushing services back a level. It has subsequently been developed across Australia and internationally, including sites now developing in England and conversations underway in Wales as part of social care and health reform.

The Asset-Based Community Development Institute (ABCD), was established in 1995 by the Community Development Program at Northwestern University’s Institute for Policy Research, is built upon three decades of community development research by Professors Jody Kretzmann and John L. McKnight.

The mutualisation of both approaches is now well advanced under the guidance of the authors of this blog. Building on long term, evidence based and innovative frameworks, these innovative approaches to supporting local citizens and communities to build and pursue their vision for a strong, mutually supportive community offer tangible answers to the five questions at the beginning of this piece. The combination balances the need to “come alongside” people who are vulnerable through age, frailty, disability or mental health issues to achieve their vision for a good life, with a community building approach which increase the competency of the wider community to co create healthier, more prosperous and hospitable communities

This maximises the opportunity for those who are most vulnerable to stay strong, use and share their personal strengths, maintain good health and personal relationships, to support people to be part of, and contribute to, their communities and to strengthen the capacity of communities to welcome and include people. At the same time, communities are identifying, connecting and mobilising their collective assets for the well-being of all members of the community, inclusive of those on the margins.

This combined offer presents as a powerful catalyst for service and systems reform, forming the new “front end” of the service system, moving the focus from assessment, funding and services to prevention, community building and local solutions, with formal services and specialist roles moving back as a “back up” to local solutions (as per “A Vision for Adult Social Care, DH, 2011).

Making it Real: Operationalising the Vision

Local Area Coordination is underpinned by 10 Core Principles and these are delivered and support by the Local Area Coordination Framework. These principles underline

• The right to citizenship, responsibilities and opportunities
• The importance of valued relationships and personal networks
• The importance of access to relevant, timely and accessible information to inform decision making
• Recognising and nurturing individual, family and community gifts and assets
• Recognising the natural expertise and leadership people labelled as vulnerable and their families
• The right to plan, choose and control supports and resources
• The value and complementary nature of formal services as a back up to natural supports and practical solutions

The LAC Framework supports the design, development, implementation and accountability/outcomes of Local Area Coordination. See “From Service Users to Citizens” (due late April 2012) or contact Inclusive Neighbourhoods for more information or support.

Short Cuts Don’t Work – A Real Opportunity to Reform Not Tinker

Local Area Coordination is NOT about adding a few tasks on to existing social work roles or just a variation on community based social work.

It (LAC) becomes the new “front end” of ths service system, pushing formal services back a level, connecting service and age types and focusing on people, families, communities.

It provides the context for re thinking the roles and desired outcomes of specialist and funded services, with an intentional preventative approach at the front end, nurturing local community resources as the primary source of support.

It focuses on assets, strengthening individuals/families/communities, practical (non service) solutions, with social work and other specialist services as robust, focused, valued back up services.

It is very different from, but works in partnership with, social work and statutory functions

Opportunities for Wider Reform

LAC and ABCD also provide the opportunity for all professionals to think about identifying, connecting and mobilising individual, family and community strengths as an important part of their roles in supporting people to stay strong or solve problems.

As a “cradle to grave” approach, embedded in local communities and developing lasting relationships with local people, it also provides the opportunity to simplify the service system for local people (a genuine single, local, accessible point of contact in the local community – across service types) and connecting/integrating service types.

The challenge is to make sure that “salami slicing” of services to save money is not the only approach and that any new initiatives don’t further complicate the system, have an evidence base and sound methodology for inclusion, non service solutions, strengthening communities and contribute to reforming existing services. Merely cutting services, without attention and investment in alternatives, substantially increases the risks of further isolation, exclusion, crises and people becoming more vulnerable. It will place further pressure on services that are already struggling to cope – an accident waiting to happen

Local Area Coordination/Asset Based Community Development and reform will require positive values and assumptions about local citizens and communities, long term commitment, leadership and vision, with real contribution and partnership with local people. A significant portion of this reform will require a sea change in attitude among managerial classes about the unique competencies of communities in the areas of health, safety, care for the environment, safe food production and consumption, local economic development, ageing well in a place/locale, building strong communities, civic action towards deeper democracy and a more just society, response to emergencies and co-producing knowledge and the limitations of system based responses in those domains

Local Area Coordination and Asset Based Community Development are about starting conversations and building connections.

They are about

• keeping communities strong so that they are competent enough as active citizens to sustain and keep each other strong
• having positive values and assumptions about people labelled as vulnerable and our local communities.
• people coming together – mutual support
• social justice
• building strong, welcoming and inclusive communities
• acknowledging and supporting the value of services and money, when delivered at the right time, in the right place and for the right reasons – as a back up to local natural solutions

It’s about more than services, money and negative labels.

Conclusion

Providing better ambulances at the bottom of the cliff instead of fences at the top is a half-baked and wasteful endeavour for policy makers and practitioners alike. This reflection piece, therefore, concerned itself with the means by which, with labelled people in the lead, families, communities and agencies can co-create better fences before the precipice, and ensure that a good life is nurtured well before people reach the “edge”. To ensure people can seek a life of their own choosing, we assert that a combined LAC/ABCD approach will prove more fruitful than current isolated deficit based approaches, exclusively concerned as they are, with the needs and problems of an increasingly growing vulnerable population.

A good life, across the life-course, in one’s own place, in a way that feels productive, surrounded by family, friends and neighbours, is everyone’s business and is worthy of greater attention than is currently being afforded to this simple, powerful ambition. The central crisis of modern health and social care system is our neglect of the task of building hospitable, competent communities where everyone can contribute their talents, skills and knowledge, while receiving the contributions of others in kind.

And so, in the final analysis we are faced with one fundamental question:

“Do we support communities and local people to build and pursue their personal and community vision and simplify services and systems to make them more personal, relevant, flexible, facilitative and accountable, or continue to tinker at the edges and adjust existing roles and services?”

The answer will define all our futures; policy makers would do well to realise they will live long enough and across the life course be at one point or another vulnerable enough to inherit the legacy of their decision: Do we tinker or reform?

LAC Network Newsletter Issue 1 out now – download via http://www.inclusionnorth.org/documents/LAC%20Newsletter%20Vol%201%20March%202012.pdf”>http://www.inclusionnorth.org/documents/LAC%20Newsletter%20Vol%201%20March%202012.pdf

LAC Network Newsletter Issue 2 due Mid April 2012

The paper on LAC in England and Wales, “From Service Users to Citizens” is due late April 2012