• From working as a social care assistant to seeing things quite differently, challenging what I’d been taught
• Stumbling across shared lives schemes and ultimately becoming CEO of Shared Lives Plus, the UK membership charity for people living and working in Shared Lives care or Homeshare.
• Shared Lives – “Shared lives schemes support adults with learning disabilities, mental health problems or other needs that make it harder for them to live on their own. The schemes match someone who needs care with an approved carer. The carer shares their family and community life, and gives care and support to the person with care needs. Some people move in with their shared lives carer, while others are regular daytime visitors. Some combine daytime and overnight visits. Shared lives schemes are available across the country and are an alternative to traditional kinds of care, such as care homes.”
• 10,000 shared lives carers in the UK
• Led to writing the book – A new health and care system: Escaping the invisible asylum – to get my head round how this successful approach could be hidden in the social care system, which generally is seen as not working very well
• Shared lives story – Andy and James
• Being able to do things you just couldn’t do in a service
• VCSE review – The review co-designed the Health and Wellbeing Alliance (20 consortia of VCSE organisations working with government and NHS to coproduce health and care policy and practice) and the Health and Wellbeing Fund. The VCSE Action Plan, published in 2018, set out two system shifts we consistently heard are needed to build a more sustainable and impactful VCSE sector, with closer and more productive relationships with national and local government and the NHS:
  • The shift towards co-designing health and care systems with citizens and communities, through working with community-rooted organisations which can reach and engage citizens from all parts of local communities. That change would lead us to redesign health and care services to be more personalised and to focus on building wellbeing and resilience, which would lead to the second shift:
  • A core role for those VCSE services which demonstrate they can provide support which is whole-person, whole-family and whole-community.
• We identified three key actions to achieve these shifts:
  • Define and measure wellbeing, embedding it as a core outcome across health and social care systems and demonstrating the links between achieving wellbeing, and improving the bottom line of local public service economies.
  • Co-design health, care and public health systems with local people: particularly with those who make most use of health and care services, and with those groups and communities who are most excluded from those services.
  • Develop and test ways for commissioners to invest in and reward the successful creation of wellbeing and resilience. These include models like social prescribing which attempt to bring statutory resources into small community organisations, in ways which work for statutory budget holders, and for civil society.
• Reflecting on the impact of the review and action plan
• Creating a new asset-based system – Asset-based thinking shifts the approach from what’s wrong to what’s strong, focusing on the capacities, skills and assets of people and communities.
• Think about “what a good life looks like rather than what a good service looks like”
• Meeting as Equals paper with NCVO and RSA – includes some of the steps to take in order to become an asset-based charity (see page 17).
• Mayday Trust – changed service / business model based on listening exercise, radically transforming their way of working, with huge success.
• Influencing the system
• Human learning systems – being a learning organisation
• Moving from proving to improving and impact measurement to learning and evaluation
• “How we work is as important as what we do as charities”
• Thinking more deeply about the power we hold as charities and who holds power
• Is the charity governance model the one we want for the charity of the future?
• “We could be approaching some really radical changes in our sector, which we should be excited about”
• Recommended reading and resources:
  • The Mayday Trust
    • The Person-led, Transitional and Strengths-based (PTS) Response
    • Become a Strengths-based Organisation
    • Become a Strengths-based Place
  • What next for strengths-based areas? – Report from the Social Care Institute for Excellence, Mayday Trust and Think Local Act Personal.
  • New System Alliance – Together, we are allies working to change the systems people come up against when they experience tough times.
  • How We Lost Sight of the Point of Public Services – Article for New Local with Chris Fox (Alex’s brother), Professor of Evaluation and Policy Analysis at Manchester Metropolitan University

You can find Alex on LinkedIn and Twitter.

A new health and care system: escaping the invisible asylum

Alex’s book, A new health and care system: Escaping the invisible asylum, argues for a complete transformation of the professional/client relationship which is at the heart of all of our long term support services. Learning from Shared Lives, Homeshare and other ‘asset-based’ models, our public services could instead be based on more reciprocal, long-term and effective relationships, which would reframe our whole health and care system around creating wellbeing and resilience for individuals, families and communities.

Reviews

This is a hard-hitting critique of our current care system – an account of why things are the way they are and how they could be different in future. Everyone who cares about health and social care should read it, and respond. –Jon Glasby, Head of the School of Social Policy, University of Birmingham

This is a profound and timely call for a different relationship between people and the services and institutions of the welfare state. It’s a radical and necessary call to arms for a more human, personal and connected society. –Simon Stevens, Chief Executive, NHS England

In this insightful book, Alex Fox gets to the heart of why attempts to reform our care and health services so often falter, and, drawing on his unique perspective, sets out a genuinely original alternative. –Matthew Taylor, Chief Executive of the RSA

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