Torri'r Cylch

Practitioner Workshop

29th March 2011

The Journey so far…

Drivers for change

“We must confront the way in which Government remains so departmental. At a time when most of our major social problems range across bureaucratic boundaries, Government

departments continue to work in relative isolation. Worse still, these silos make it

excessively difficult for local agencies to work together sensibly for the benefit of citizens.”

Sir Michael Bischard

• The need to:– Tackle high cost services in line with the drive to

deliver efficiencies• Taking planned and controlled action to look at cost and

quality and aim to deliver more for less• Focus not only on efficiency but also effectiveness

– Targeted, personalised and preventative

• The need to deal with the causes not the symptoms to unlock particular problems

• Opportunity to translate national policy and strategy within a local context and draw on positive practice

• Opportunity to work collaboratively– working across boundaries towards a common

goal

Methodology and Your involvement

Modelling costs

Planning next steps

Defining Vulnerable Families

Creating pen portraits Calculating costs

1st Workshop

User involvement through Clywed

2nd Workshop

3rd Workshop

Task 1

How was it for you?

Capturing your thoughts

Positives• Philosophy was widely shared – motivating

• Communication was good between Tribal, Council and Agencies – support was good.

• Process was very useful in getting a fuller picture of families

• Also highlights gaps in the systems and information that services hold

Capturing your thoughts

Areas for improvement• Earlier involvement for those practitioners that were going to be collecting the information

– consistency of people involved throughout the process – identify the people and the services that we needed involve as early as possible

• Sample of families cold have been different with earlier involvement – doesn’t affect the key themes and findings, but in future should include all the stakeholders

• Snapshot means that the full family experience is not captured, nor is full cost of families. More important for some services than others – Justice is more intermittent

• Did pen portraits capture all significant others? – possibility that males are under represented. This may also represent a bias in service provision (usually work with mum, not dad)

• More information (leaflet maybe) to outline the process to allow better planning of resources required for the project.

• Earlier indication of what was needed for costings would heave been better.• Data sharing was a concern, but that reflects general concern about data in everyday

wok with vulnerable families.• Tight timeframe

Key themes

The vulnerable Family

Reactive rather than proactive services –

lack of early intervention

No single points of contact – confused service provision

Referral points and thresholds do not promote a joined up approachService retracts only to have to respond again at a later date

Services each have a piece of the jigsaw but no one has

a holistic view

Key Themes• Continual pattern of intervention – despite

minimal impact

• Not enough early intervention – its proven in other areas but not enough investment at present– Early intervention and early years

• IT systems and infrastructure– Doesn’t support joint working– Clearly a consideration for the future

Key themes Positive impact upon the ‘upstream’ focus on interventions to reduce the

total public sector expenditure on ‘vulnerable families’

Inpu

t of t

otal

pub

lic s

ecto

r res

ourc

es (£

)

‘Conituum of Need’

Universal Targeted

Lifetime

Statutory

Breaking the Cycle

“from fragmentation to

integration”

Earlier and co-ordinated targeted

interventions

Status quo: Escalating lifecycle costs that will

be subject to demographic pressures

Total ‘Cost curve’ as a result of

early intervention

Key ThemesAggregating up from individual families, early intervention may reduce the overall cost of providing services for vulnerable families

Key Themes

The costing exercise is not yet complete, but from the data so far:•The extra cost of our 30 families to services in Gwynedd is around £325,000 per annum•Family 1 is the most costly in our example, with over £50,000 per year additional cost to local services.•The total annual cost of these services in Gwynedd is c. £13million•Preventative interventions cost 75-80% less than protection or remedial services on average.

Task 2

Your thoughts…

Capturing your thoughts

• Central referral point and joint systems – shared ICT or else a shared location where people can talk to each other

• Never ‘closing’ cases – there should be ongoing monitoring and support for families as they recover from crisis or risk is reduced – if things go wrong again we will be quicker to react – prevent re-referral, and react quicker if there is re-referral – issues of dependency

• Accountability is an issue with deregistration – review after 3-6 month will increase accountability

• GPs should be involved in signposting more frequently (issues of confidentiality). GP localities may be a route to better working with multiple services and with each other.

• Educating people to be better parents at school, and using schools and teachers to identify risk.

Capturing your thoughts

• Generally happy, but need more focus on outcomes over costs. Need to make the relationship between outcomes and cost more explicit. Also need outcome frameworks to establish true value for money.

• Need for short term investment at a time when we need to frontload cost savings. Prevention and early intervention are being cut because they are non-statutory. Need to measure outcomes to show the effectiveness of interventions, and to show cost savings across budget boundaries

• Need to think about how to profile families and target services.

• Middle heavy structure – more generalist staff cost less and can be more effective in early intervention

• Engagement with families to test the outcomes and impact of the project

Classification of interventions

Next steps• Torri'r Cylch as a brand which draws

together several strands of work to better target services for vulnerable people– Replicated across other services

• A commissioning model at partnership level (e.g.Leicestershire LSP)

• Relationship Management– Single point of contact for families with multi

agency support (Kent) / Family buddies– Agreement in place between agencies and family

– joint responsibility to tackle the problem (Westminster and numerous Housing Associations)

Vulnerable Family

Continuum of Need

Integrated Family

Support Services

Team around the Child/Family

Families First

ProtectionTargeted resources for families with additional

needs

PreventionUniversal services recognise risks of vulnerability and

target them through preventative interventions

RemedyHolistic

interventions that tackle the complex needs of the most vulnerable families to help break the

cycle

Families First will focus on early intervention and

preventing families from developing more complex

needs.

Torri'r Cylch focuses on co-ordinating integrated

services and encouraging early intervention to prevent

vulnerable families from developing more complex and more costly needs.

Next steps

• Arms length organisation acting as a broker and driver for change– Led by the Programme Board and supported by a

Programme Team

• Outcome framework (Westminster)– to track progress with a flexible approach to measurement– A basket of indicator applied on the basis of a

targeted intervention – measured at family level and strategically

Next steps• Ensuring the voice of the service user is at the

core of any change• More early intervention (shifting investment

and resource:– Extension and roll out of successful programmes that

exist but connecting these more closely

– Introducing additional early interventions such as:

• Parenting classes (Kent and Croydon)

• Particular training and development opportunities – up skilling for collaboration

• Removing barriers to work etc

Next Steps• Finalise costing exercise• Finalise user involvement exercise• Final Project Board Meeting- 13th April• Test case due to complete by mid April including

cost sensitivity analysis with a launch event planned shortly after

• Move to detailed business case and brokerage• Potential legacy funding arrangements

– Families First Programme - (Gwynedd, Isle of Anglesey and Conwy announced as Pioneer Area (additional £750K during 2011/12)

– ESF Priority 4 (match funding application planned for May 2012)

– Big Lottery Funding (£20 million available under the Improving Futures Programme)

– Core funding from partners – pooled resources