Transcript System Evaluation Results

GM Public Service Reform
Complex Dependency
April 2014
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Complex Dependency Priority
• Tackling issues of complex dependency is a key reform
priority for GM. This involves:-
– Scaling up PSR principles to a broader cohort (e.g. those
leaving the Work Programme, offenders, those involved in
organised crime, and those with complex health needs)
and a deeper cohort (e.g. families at risk of becoming
troubled; those in low pay, no pay cycles that may also
have complex needs).
• Complex Dependency will have a sharper focus on
employment and skills progression.
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2014-15 Commitments
Already working intensively with subsets of complex
dependency cohort:
• Troubled Families (worklessness, truancy, crime/ASB)
• Intensive Community Orders (18-25 yo offenders)
• Work Programme Leavers (ESA claimants)
• Health & social care (working age adults with complex
health needs)
• Families linked with organised crime
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GM co-design with Government
• Early adopter for next phase of Troubled Families
• Improved mental health offer for workless residents
• Test impact of Universal Credit prior to roll out
• Supporting those in cycles of low pay, no pay – based on
more flexible skills offer
• Match mainstream adult skills budget with GM ESF at
source – establish robust tracking mechanism
All underpinned by longer term place based settlement,
with shared risk & reward for investing in reform.
Aim to inform future options for Work Programme
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contracts.
Complex Dependency Cohorts
Work to date to define the cohort suggests that issues
associated with complex dependency fall into four broad
areas:
• Employment and low skills (e.g. Worklessness, Low pay, no
pay, Low skills)
• Crime and offending (e.g. Repeat offending, Domestic
Abuse, Organised Crime)
• Health (e.g. Mental health, Long term conditions, Drug &
Alcohol misuse)
• Children and young people (Children in Need, Child
Protection Plans, Looked After Children, Early Years, School
attendance)
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Cohort Overlap (Manchester)
4,000 Troubled
Families
10% of probation cases are
from Troubled Families
8,000-10,000 At-Risk
Families
11,000 Offender Families
(inc 2,000 ASB families)
Workless Troubled Families:
- 25% families claiming JSA
80% of offender families due to
offences by adults only
(1,052 people from 925 families)
- 32% families claiming ESA
(1,383 people from 1,292 families)
25% of Troubled Families
have children aged 0-5
- 27% families claiming IS
(1,142 people from 1,104 families)
30,000
Families with
Children Aged
0-5
43,000
Workless Families
80% of Troubled Families with
children aged 0-5 are also workless
- 15% families claiming CA
(629 people from 607 families)
All Out of Work Benefit Claimants:
31% claimants claiming JSA
53% families claiming ESA
12% families claiming IS
(Based on 59,700 individuals/claimants)
3,200 Children with Child in
Need Status
2-5% of individuals with suspected
links to organised crime are from
Troubled Families
(550 are in Troubled Families)
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Cohort Needs
Total complex dependency cohort in GM expected to be in
excess of 100,000 individuals. Segments of the population
will include those who:
a) create the highest demands and costs, including many of
the first phase Troubled Families;
b) have medium levels of need;
c) are at risk of having complex needs in the future; and
d) do not require support beyond universal services.
Most complex cases will be relatively straightforward to
identify through intelligence and systems. More difficult to
identify less complex, involving complex assessments of risk
and need.
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New Delivery Models
• co-designed with partners, based on PSR principles and
Troubled Families ways of working:
– integration, sequencing and prioritisation of public services
to form bespoke packages of support, coordinated by key
workers;
– deploying interventions with a strong evidence base;
– integration of services on a whole family basis, not just for
individuals.
Supported by:- workforce development, information &
intelligence, sanctions & conditionality, joined up
commissioning across GM.
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Customer Journey
REFERRALS FROM RANGE
OF AGENCIES
INITIAL ASSESSMENT OF LEVEL OF NEED BY
INTEGRATED TEAM OF PUBLIC SERVICES
LEAD KEY WORKER ALLOCATED. COMMON
ASSESSMENT OF WHOLE FAMILY
INTENSITY OF KEY WORKER SUPPORT WILL
VARY. KEY WORKERS MAY BE SPECIALISED
KEY WORKER DEVELOPS ACTION PLAN WITH FAMILY. KEY WORKER CREATES BESPOKE PACKAGE OF
SUPPORT. MANAGES INTEGRATED AND SEQUENCED ‘TIER 2’ INTERVENTIONS, E.G. DRUG AND ALCOHOL
MISUSE, MENTAL HEALTH, DEBT, EMPLOYMENT, PARENTING. INCLUDES COMMUNITY ASSETS
ONGOING MANAGEMENT OF CASES. OPTIONS TO STEP UP/DOWN
SUPPORT. ONLY CLOSE CASE WHEN CHANGE SUSTAINED
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Asks of Government
• Continue process of co-design.
• Support laying foundations for more radical reform:– Multi-year budgets
– Devolved accountability
• Work on national enablers of reform, removing barriers:– Data sharing (particularly employment & health)
– Place-based systems for regulation and inspection.
Encourage partners to deal with whole families, rather than
single issues.
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Complex Dependency in Salford
• Given this context we need to understand:– the needs and assets of our city, people and communities;
– which services deliver most impact
– how we manage access to those services given our reduced
budget
• We now have a unique opportunity to bring together the
GM PSR work, Salford’s Joint Strategic Needs Assessment
(JSNA) refresh and the developing Financial Strategy for the
City into a design that incorporates our key learning to date
from PSR.
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Understanding Needs & Assets
• Robust intelligence is fundamental to enable long term
planning and decision making that will support innovation
and sustain outcomes for the city.
• The JSNA will be Salford’s ‘single version of the truth’ and
should provide the evidence for intelligence led decisions
about where to invest or reduce spending to improve the
well-being of our individuals and communities.
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Evidence Based Interventions
• Ensuring that the services and interventions we deliver and
commission have a strong evidence base will give us the
confidence that we are investing in those things that have
the greatest impact.
• New interventions should be chosen on the strength of the
best available evidence but will also require a review of the
ability of existing interventions and services to meet the
needs of people and communities
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Salford’s Approach
JSNA
Single front door
with clear thresholds
• Understanding
the needs and
assets of our city,
people and
communities
• Defining key
cohorts
Workforce
reform / ICT
• Co-ordinated
access to targeted
and specialist
‘People’ services
• Resource
allocation based
on assessment of
risk
• Clear service
thresholds that
reflect the nature
of complex
dependency
Integrated delivery
• Integrated, coordinated and
sequenced
support at the
right time, in the
right order
• Family based
approach
• Interventions
chosen on
strength of
evidence base
Design and Delivery Team:
Informs, supports and quality assures the work of the Enabling Hub. Plus delivery of specific
products: Service Gap Analysis, Process Design, Service Design, Specification Development, Financial
Analysis
Strategy and Change Function (Enabling Hub):
Data analysis including: Define Cohort, Spatial Analysis, Family Stratification, Modelling and
Demographic Projections, Impact Evaluation, Financial Analysis
Ask of Partners
• Support design and delivery team to develop a proposition
& specification for this work.
– Feed into the evidence gathering required to understand
needs and assets in the city
– Provide support and resources for a single front door
– Help define service access thresholds – broader than social
care
– Integrate delivery resources for Team around the Family
– Share examples of best practice / impact evaluation / costs
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