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”Understand the Economics of
Real Help SystemsBy
Karl RobinsonStoke-on-Trent City Council
17th October 2013
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What Does Success Look Like?• Problems We Wanted to Solve– Does this way of working improve things for our
residents?– Is this way of working Affordable and Scalable?– Will it reduce demand on the whole system?– What are the links to the Cross Economy system and
the Problems they have to solve e.g.• Health – Reducing the demand on A&E admissions• Police – Reducing the number of both uniformed
and non uniformed staff without compromising the service• Social Care – Getting better results with less resources i.e.
impact of having Children in Care
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Understand the Customer
“C” “W”
0123456789
10
Help me to feel betterabout myself
Help me to provideequipment to support
my childs education
Help me to getnecessary repairs to my
property
Help me to getemployment
Help me to maintain mygarden
Help me to getnecessary furniture for
my home
Help my ex-partner withhis housing need so he
can see his children
Help me to manage myfinances
Help me to get trainingfor future employment
"C"
Jan-13
Mar-13
Aug-13
0123456789
10
Help me with suitable andbigger accomodation for my
large family
Help me with my debts
Help me with managing myfinances
Help me to get employment
Help me with basic food
Help me with problems at mysons school with bullying
Help me with my relationshipand trust issuesHelp me with my benefits
Help me with problems thatchildren are causing on the
estate with my son
Help me to get rid of myrubbish
Help me with my childrenstravel to school
Help me to provide/get freeschool meals for my children
Help me with my childrenstransfer to a new school
"W"
Jan-13
May-13
Aug-13
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Demands in Context
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Comparing Old and New Costs• We needed a way to understand the costs both
before and after working with citizens in a different way.
• Options We Explored:– Develop a new cost model
• Too complex and time consuming to produce a robust model;
– Identify an already available cost model that is:• Already validated and nationally recognised;• Easy to understand and adapt as we learn more about
systemic economics
• Solution we Identified• The DFE Cost Calculator Model
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The Approach To Understanding Costs• Old World– Identify all activity that had been carried out on
individual citizens for a 2 year period prior to working with them in a different way
– Collect all this data across partner agencies
• New World– Activity based on resolving ‘Demand in Context’ at
individual level– People presenting through:
• Rent Arrears, Police, etc• Locality = 1 Ward in Little Chell and Stanfields
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Result:Cost Comparison at Individual Level
Yr1 Q1 Yr1 Q2 Yr1 Q3 Yr1 Q4 Yr2 Q1 Yr2 Q2 Yr2 Q3 Yr2 Q40
50
100
150
200
250
Cummulative Comparison of Pre and Post-Intervention Activity: K
Pre-Interventioin Transactions (Cummulative) Post-Interventioin Transactions (Cummulative)
Yr1 Q1 Yr1 Q2 Yr1 Q3 Yr1 Q4 Yr2 Q1 Yr2 Q2 Yr2 Q3 Yr2 Q4 £-
£5,000 £10,000 £15,000 £20,000 £25,000 £30,000 £35,000 £40,000 £45,000 £50,000
Cummulative Comparison of the Number of Pre and Post-Intervention Transactions: K
Pre-Interventioin Cost (Cummulative) Post-Interventioin Cost (Cummulative)
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Developing the Measures Framework• Approach– Identify set key strategic measures• 35 key measures identified including Rent Arrears no’s,
Rent Arrears £’s, Police ASB No’s, Rent Notices of Serving Possession (NOSP’s), etc
– Feed in cases to the Locality Team from Little Chell and Stanfields
– Produce data to compare Little Chell and Stanfields with City wide and 2 control groups in capability chart form to understand how the new way of working impacts on the measures
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What we Learnt from the Measures
Strategic Measures
Individual Measures
?• How do we know
who to intervene with?
• Can we make these people visible? -
The Missing Link Tier 2
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The Tier 2 Matrix
Street number Street name PoctcodeCYP Referral
CYP Re-referral
CYP asst. to service
Rent Arrears YAMH ASB VA Crime
Count of Flags
A CARSON ROAD ST 6 7BG Y N N Y N N N Y 3B CROSSLEY ROAD ST 6 7AJ Y N N Y N N N N 2C BARNETT GROVE ST 6 6NA Y N N N y N N N 2D CROSSLEY ROAD ST 6 7AJ Y Y Y N N N N Y 4E CROSSLEY ROAD ST 6 7AJ Y N N N N N N Y 2F CROUCH AVENUE ST 6 7HT Y N N N N N N N 1G GALLIMORE CLOSE ST 6 4DZ Y N N N N N N N 1H GREENBANK ROAD ST 6 7EY Y N N N N N N Y 2I HUNTILEE ROAD ST 6 6EP Y N N N N N N N 1J IRENE AVENUE ST 6 7HB Y N N N N N N N 1K IRENE AVENUE ST 6 7HB Y Y N N N N N N 2L NORRIS ROAD ST 6 7AS Y N N N N N N Y 2
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Tier 2 Challenges
• Data Sharing
• Partner Data
• Measuring changes to cases meeting Rebalance Me triggers
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Cost Analysis Comparison
PoliceSocial Services Health ServiceLocal Authority Education
£2k
£6k
£10k
Historic Approach
Principles-Based Approach
£ 83,649
£ 824
£ 3,379£4k
£8k
£12k
£14k
£80k
£ 646
£ 2,859
£ 214
£ 3,818
£ 33 £ 493
Principles-based Approach£ 2,210
2%
£££99%
£££81%
£££93%
£££99%
£ 106,777 Historic Approach
Multi-agency Mtngs
0
2
4
6
8
10
I am listened to and heard
I have more confidence
My financial problems are
sorted
My children can sleep in their
own room
My children have space to
play
I have some space of my
own
I am able to manage my
home better
Our sleeping arrangements do not affect …
Start
29.06.12
24.09.12
Tier
1 –
Indi
vidu
alO
utco
mes
/ Ec
onom
ics
Tier
2 -
Geo
grap
hyCa
paci
ty /
Scal
abili
ty
Tier
3 –
Str
ateg
icD
eman
d Re
ducti
on
& C
ost R
emov
al
Street number Street name PoctcodeCYP Referral
CYP Re-referral
CYP asst. to service
Rent Arrears YAMH ASB VA Crime
Count of Flags
A CARSON ROAD ST 6 7BG Y N N Y N N N Y 3B CROSSLEY ROAD ST 6 7AJ Y N N Y N N N N 2C BARNETT GROVE ST 6 6NA Y N N N y N N N 2D CROSSLEY ROAD ST 6 7AJ Y Y Y N N N N Y 4E CROSSLEY ROAD ST 6 7AJ Y N N N N N N Y 2F CROUCH AVENUE ST 6 7HT Y N N N N N N N 1G GALLIMORE CLOSE ST 6 4DZ Y N N N N N N N 1H GREENBANK ROAD ST 6 7EY Y N N N N N N Y 2I HUNTILEE ROAD ST 6 6EP Y N N N N N N N 1J IRENE AVENUE ST 6 7HB Y N N N N N N N 1K IRENE AVENUE ST 6 7HB Y Y N N N N N N 2L NORRIS ROAD ST 6 7AS Y N N N N N N Y 2
16 %
75 %
I could go either way
I am in balance but I need a little help
6%
I am in need of serious help
Our New Measures Framework
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Tier 3
Tier 2Tier 1
Street number Street name PoctcodeCYP Referral
CYP Re-referral
CYP asst. to service
Rent Arrears YAMH ASB VA Crime
Count of Flags
A CARSON ROAD ST 6 7BG Y N N Y N N N Y 3B CROSSLEY ROAD ST 6 7AJ Y N N Y N N N N 2C BARNETT GROVE ST 6 6NA Y N N N y N N N 2D CROSSLEY ROAD ST 6 7AJ Y Y Y N N N N Y 4E CROSSLEY ROAD ST 6 7AJ Y N N N N N N Y 2F CROUCH AVENUE ST 6 7HT Y N N N N N N N 1G GALLIMORE CLOSE ST 6 4DZ Y N N N N N N N 1H GREENBANK ROAD ST 6 7EY Y N N N N N N Y 2I HUNTILEE ROAD ST 6 6EP Y N N N N N N N 1J IRENE AVENUE ST 6 7HB Y N N N N N N N 1K IRENE AVENUE ST 6 7HB Y Y N N N N N N 2L NORRIS ROAD ST 6 7AS Y N N N N N N Y 2
Cost Analysis Comparison
PoliceSocial Services Health ServiceLocal Authority Education
£2k
£6k
£10k
Historic Approach
Principles-Based Approach
£ 83,649
£ 824
£ 3,379£4k
£8k
£12k
£14k
£80k
£ 646
£ 2,859
£ 214
£ 3,818
£ 33 £ 493
Principles-based Approach£ 2,210
2%
£££99%
£££81%
£££93%
£££99%
£ 106,777 Historic Approach
Multi-agency Mtngs
0
2
4
6
8
10
I am listened to and heard
I have more confidence
My financial problems are
sorted
My children can sleep in their
own room
My children have space to
play
I have some space of my
own
I am able to manage my
home better
Our sleeping arrangements do not affect …
Start
29.06.12
24.09.12
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What Does the Measures Framework Tell Us About Working in the New Way?
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Impact on the Strategic Measures – Tier 3
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Rent Arrears - Housing tenants in arrears (amount)City Pilot Geography
Comparative Geography 1 Comparative Geography 2 0.8% Increase
5.5% decrease
13.9% decrease
1.27% decrease
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Rent NOSPsCity
6.1% increase 1.56%
decrease
33% increase
No changeComparative Geography 1 Comparative Geography 2
Pilot Geography
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Police ASB reported casesCity ASB
21% increase 5.2%
decrease
5.9% increase
23.8% increase
Comparative Geography 1 Comparative Geography 2
Pilot Geography
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Crime reported casesCity Crime
8.8% increase
No change
9.2% increase 14.9%
increase
Comparative Geography 1 Comparative Geography 2
Pilot Geography
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Impact at a Systems Economic Level – Tier 1
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Tier 1 – Whole System Activity and Economics
0
50
100
150
200
250
Pre-intervention post-intervention
99% 174%
10%
80%
95%150% Pre: 0
Post: 4
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Tier 1 – Whole System Activity and Economics
Local Author-ity
40%
NHS18%
Police40%
Local Author-
ity84%
NHS7%
Police4%
Pre Intervention Activity Post Intervention Activity
Fire11%
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Tier 1 – Whole System Activity and Economics
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Fire Service4%
Local Author-ity
36%
NHS41%
Police17%
CAB1%
Pre Intervention Activity Post Intervention Activity
Police31%
NHS13%
Local Auth. 6%
CriminalJusticeSystem49%
Fire Service 1%
Tier 1 – Whole System Activity and Economics
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Cumulative Pre & Post Intervention Activity: 7 Cases
Pre-Intervention Activity(Cumulative)
Post-Intervention Activity(Cumulative)
Tier 1 – Activity and Economics
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Cumulative Pre & Post Intervention Activity: 7 Cases
1,480
Tier 1 – Activity and Economics
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Difference : 470
Cumulative Pre & Post Intervention Activity: 7 Cases
1,480
1,010
Tier 1 – Activity and Economics
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Cumulative Pre & Post Intervention Cost: 7 Cases
Tier 1 – Activity and Economics
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Cumulative Pre & Post Intervention Cost: 7 Cases
£337,000
Tier 1 – Activity and Economics
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Cumulative Pre & Post Intervention Cost: 7 Cases
Difference : £104,000£337,000
£233,000
Tier 1 – Activity and Economics
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Is it Scalable?
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Tier 2 – Matrix
• Key findings from the matrix:• The data suggests that there is a total potential for 5482
Rebalance Me cases across the city.• Using the model of 16 ongoing cases per worker, we would need
368 workers to deal with these cases over a 12 month period. • Using the model of 16 cases per worker, we would need 119 staff
to deal with the total caseload over three years. • For the test area of Little Chell and Stanfields, there are 176 cases
now identified through the matrix.
1. We can estimate the total potential caseload and demand types across any geography from a street to whole city level
2. We can use the matrix to identify and prioritise caseloads for allocation to staff, ensuring we can approach those who need help, rather than relying on picking them up through a presenting demand anywhere within the system
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Triangle of Need
1,2051%
18,05217%
88,24382%
6%
28%
65%
Specialist, Multiple NeedsRe-balance MeBAU-Housing
I am living my life well
I could go either way
I’m in need of
serious help.
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Is It Affordable?
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Tier 1 – Activity and EconomicsEconomic Comparison (liner chart over time):
£337,000
£233,000
Difference : £104,000
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A Summary of the Potential Savings
• The model estimates savings of around £104,000 for the seven cases reflected. This would equate to an average saving of £14,857 per case.
• Potential savings of around £81.5m (across the partnership) that could be delivered in line with roll-in plan.
• Note– Small sample size and needs to be validated as cases are added
into the analysis to make it more statistically robust. – This goes back to one of the data sharing issues we highlighted
earlier.