Infographic Summary of the StrategicNeeds Assessment March 2020

Produced for the Home Office March 2020Infographics created by: Benita Branagan

Contents

1. Introduction

2. Bedfordshire Demographics

3. Problem Profile

4. Risk and Protective Factors

5. Prevention- The evidence base

6. Recommendations

Produced by the VERU (Violence and Exploitation Reduction Unit)Authors: Megan Gingell, Ade Abitoye, Benita Branagan

Introduction Violence and exploitation are key public health issues, influencing the health andwellbeing of populations, and leading to significant inequalities within populations.Violence and exploitation can have an impact right across the life course, withpotentially devastating consequences.

VVEERRUU

In August 2019, the Bedfordshire Violence andExploitation (VERU) was set up. ViolenceReduction Units (VRUs) are multi-agency units,bringing together local partners to tackle andprevent serious violence. The BedfordshireViolence and Exploitation Reduction Unit (VERU)aims to prevent and reduce violence andexploitation across Bedfordshire (BedfordBorough, Central Bedfordshire and LutonBorough) by taking a whole systems multi-agencyapproach to violence and exploitation.

Using local data and intelligence to identify thecurrent burden and risk of serious violence is akey element of the public health approach toviolence prevention. A Strategic NeedsAssessment (SNA) enables a local area to identifycurrent and long-term issues relating to seriousviolence and the cohorts most vulnerable toinvolvement in their partnership area. Thisprovides a greater understanding of establishedand emerging serious violence trends, prioritylocations or other high-risk issues.

AAIIMMSS ooff tthhee SSNNAA1. To provide a descriptive epidemiology of violence and exploitation (by time, place, andperson)2. To highlight the geographical patterns of violence and exploitation acrossBedfordshire and “hot spot” areas; describe the prevalence of risk and protectivefactors related to violence and exploitation and explore the perceptions and attitudestowards violence and exploitation across Bedfordshire.3. To provide a summary of a rapid evidence review of interventions to reduce violence.The Strategic Needs Assessment highlights areas for further analysis and research, andwill be used to inform the Violence and Exploitation Reduction Strategy for Bedfordshire.

Bedfordshire DemographicsPopulation Demographics

Index of Multiple Deprivation

Age and Ethnicity

The map shows population density acrossBedfordshire. The majority of small areas inBedford and Central Bedfordshire Council areasare relatively sparsely populated, with less than529 people estimated to be living within everysquare kilometre.

The most densely populated areas inBedfordshire are in Luton and in central areas ofBedford and in the south of CentralBedfordshire.

669,338171,623 283,606214,109Bedford

CentralBedfordshireLuton

(2018 Mid-Year estimates, published by the Office for NationalStatistics, June 2019)

Total Population

25.7%

13%

of the small areas inBedfordshire are in the mostaffluent fifth in England

of the small areas inBedfordshire are in themost deprived quintile inEngland

Bedfordshire proportionally hasmore children aged 14 yearsand under and more people intheir 30s compared to the EastRegion and England. Lutongenerally has a youngerpopulation when compared tothe other two boroughs.

77.5%13.9%4.8%3.0%0.8%

White Asian/ Asian BritishBlack African, Caribbean,Black British Mixed/Multiple EthnicGroupsOther

Almost a quarter of Bedfordshire(22.5%) are from a Black, Asian

and Minority Ethnic (BAME) group.In Luton 45% are from a BAME

group and 3 in every 10 people areAsian or Asian British. Central

Bedfordshire is the least diversewhere 94 in every 100 people are

white.

The map shows Index of Multiple Deprivation- a relative measure of deprivation - of smallareas across Bedfordshire.

Problem ProfileThe StNA includes temporal analysis of violent crimes including: knife and firearms crimes,residential burglary, robbery, homicide, sexual assault, domestic abuse, child sexual and criminalexploitation.

The overall crime rate per1,000-weightedpopulation is higher inLuton.

A large number of violencerelated hospital admissions alsohad a "mental health" specificICD code listed in the diagnosticfield.

The greatest proportion of violence related hospitaladmissions was in 20-29 year olds.

Strongassociation

betweenOCGs/County

Lines, firearmsand drugs

supply.

Increasingnumber of

recorded knifeand firearms

crimes.

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Key Findings

Hospital Episodes Statistics (HES)

Need to develop agreater

understanding ofthe link between

Child SexualExploitation,

Missing and CountyLines.

Domestic Abuse, Sexual Assault and Child Sexual Exploitation

WeaponsDrugs and OCG'sLack of understandingabout the demographicsand role of females whoare involved with gangsand county lines.

Drugs misuse stronglyassociated with mentalhealth conditions andalcohol dependence.

Serious Acquisitive CrimeFurther analytical work is required tounderstand crime patterns associated withSAC, including knife crime, gun crime andserious youth violence.

Inter-generational ViolenceLack of local data, and nationalresearch aboutinter-generational violence.

Further analysis is required tolook at the demographic profileof both victims and offenders foreach specific type of crime.

However, these are still under-reported crimes, withonly a very small proportion

being recorded.

Risk and Protective FactorsRisk and Protective factors may be at play at an individual, relationship community or societal level, as outlinedby the World Health Organisation in their report “World report on violence and Health,” published in 2002. Thisecological model highlights that there is not one risk factor, or protective factor that causes someone to be atincreased risk of being involved in violence. Risk and/or protective factors at each of these levels interact, whichmay lead to the outcome of an individual or group of people becoming involved in violence and/or exploitation.

Risk Factors

Protective Factors

High incomeinequality

Poverty

Access to andmisuse of Alcohol

Access to and misuseof firearms

Gangs and a localsupply of illicit drugs

Low parentalinvolvement

Inconsistentparental

disciplinarypractises

Unemploymentin thefamily

Poorsupervisionof child by

parent Parental

depression Low incomefamily

Delinquentpeers/gangmembership

Parentalsubstancemissuse

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Warm parentyouth

relationships

Interacting withpro-social nonviolent peers

Children feelingconnected totheir school

Parentsdemonstrate

interest in theirchild's education

and social life

Positiverelationshipswith teachers

Parents who setconsistent

developmentallyappropriate

limits

Household financialsecurity + Safe and

stable housing Access to services

and support

Economicopportunities

Residents willingnessto assist each other +collective views that

violence isntacceptable

Community spaces that aredesigned to increase

visibility, control accessand promote positive

interactions

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Schools, parks andbusiness areas

regularly maintained

ACE'SRisk and Protective Factors Cont'd

Adverse Childhood Experiences (ACEs) aredefined as “highly stressful, and potentiallytraumatic, events or situations that occurduring childhood and/or adolescence.” ACE'sinclude:● Maltreatment● Violence and Coercion● Adjustment● Prejudice● Household or family adversity ● Inhumane treatment ● Adult responsibilities● Bereavement and SurvivorshipForms of Adverse Childhood Experiences and the impact on young people. Sourced from: Young Minds, Health Education England. Addressing Childhood Adversity and Trauma [Internet]. 2018.

Bedfordshire Prevalence Estimates Prevalence estimates for Bedfordshire of some of the risk and protective factors of violence and exploitation areavailable through fingertips and local school survey data. Key findings are displayed here.

RRiisskk PPrrootteeccttiivveeLearning Difficulties

Higher proportion of pupils withLearning Disability (% of schoolaged pupil) and rate of childrenwith moderate learning difficultiesin Bedford Borough and LutonBorough.

Significantly higher rate ofchildren with severe learningdifficulties in CentralBedfordshire and LutonBorough.

SchoolsSchool readiness is lower inBedford Borough and LutonBorough, and school readiness atthe end of reception in childrenwith free school meal status issignificantly lower in CentralBedfordshire.

Significantly higher rates offixed period exclusion due topersistent disruptive behaviourin Central Bedfordshire andsignificantly across all threeLocal Authorities.

Risk Taking BehaviourHigh proportion of risk takingbehaviours in young people(secondary school) across thecounty: including taking illegaldrugs, alcohol and smoking.

Significantly, higher percentageof 15-year olds who are regulardrinkers in Central Bedfordshirecompared to its deprivationdecile.

Looked After ChildrenHigher rate of children under ageof 18 in need due to abuse orneglect across all three LocalAuthorities compared to theirrespective deprivation deciles.

Higher proportion of childrenliving in income deprivedhouseholds in Bedford Boroughand Luton Borough.

Limited evidence-base for “protective”factors for violence and exploitation.

Work with academic partnersand Public Health England toundertake of the protective

factors associated with specifictypes of violence and

exploitation.

RECCOMENDATION

Well-being Average wellbeing score of 15-year olds is similar to deprivation decileaverage for all three local authorities

RECCOMENDATIONUndertake a stakeholder

event to help map risk andprotective factors across thesystem, to provide a greater

understanding of what a“whole systems approach”

could look like acrossBedfordshire.

Prevention: The Evidence BasePrimary

Secondary and Tertiary

Schools: most promising/bestevidence/works

Individuals and Families: mostpromising/best evidence/works

Community: most promising/bestevidence/works

● Good quality early education- (preschool/earlychildhood development programmes)- addressing violenceprevention risk factors● Strengthen skills in young people and connect youth tocaring adults ● Life and social skills development/training● Bullying prevention programmes● Therapeutic approaches for young people at risk ofbeing involved in violence (family therapy/multi-system)

● Creating a supportive family environment● Parenting programmes, including community-basedparenting programmes

Individuals and Families: mixedevidence● Home Visiting

● Reducing access to and the harmful use ofalcohol● Alcohol pricing● Limiting alcohol sales● Reducing access to and misuse offirearms/changes to firearms policy● Drug control programmes● Spatial modification and urban upgrading● Poverty de-concentration● Street lighting● Changing community norms (includingmass media)● Community- and problem-orientatedpolicing

Individuals and Families: mostpromising/best evidence/works● Therapeutic approaches” in general in WHO 2015(Family therapy in EIF What Works, multisystem therapy inSerious Violence Strategy) (strongest evidence)● Cognitive Behavioural Therapy for offenders (strongestevidence● Restorative justice● Therapeutic Foster Care● Mediation between offender and victim● Vocational training (including skills building)● Trauma-focused cognitive behavioural therapy

Community: most promising/bestevidence/works● Hotspots policing● Healthcare screening for domestic abuse● Community and problem-oriented policing

Community: promising or limitedevidence● Hotspots policing● Gang and street violence prevention programmes

Individuals and Families: promisingor limited evidence ● Vocational training (including skills building)● Mentoring● A second visit to the home of domestic abusevictims (24 hours- 14 days after initialresponse)

Diagrams created by authors using information from "Susie Roberts, West Midlands Violence Prevention Alliance. Approaches to prevent or reduce violence with a focus on youth, knife andgang-related violence, literature review 2019" mapped against the CAPRICORN diagram "Public Health England. Collaborative approaches to preventing offending and re-offending in children( CAPRICORN ) A resource for local health & justice system leaders to support collaborative working for children and young people with complex needs. 2019; Available from:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/828228/CAPRICORN_resource.pdf

RecommendationsThis needs assessment provides a high-level summary of the scale of violence and exploitationacross Bedfordshire, and the cohorts affected. It outlines some of the “risk” and “protective” factorsand provides a rapid review of the evidence base behind primary, secondary and tertiary prevention.It is a key recommendation that this SNA is a “live document,” which considers new and emergingtrends and patterns and is refreshed annually.

Use the key findings from this SNAto guide the strategic objectives forthe Bedfordshire VERU. Refresh thestrategy after the consultationprocess of the SNA has beencompleted.

Further analysis is required to look atthe demographic profile of both victimsand offenders for each specific type ofcrime.

Further analytical work to mapthe hot spots of violent offencesagainst the night-time economy.

Collaborative working with the 3CSP's and VERU to supportrecommendations made within theDrugs Market Profile.

Further analytical work tounderstand the injury ratesassociated with knife crime and thepattern of other violent crimesassociated with knife crime

Further analytical work tounderstand the potential underreporting of domestic abuse andsexual abuse crimes.

Undertake stakeholder consultations toexplore and interpret the key findings inthe SNA. Hold a stakeholder event tohelp map risk and protective factorsacross the system, to provide a greaterunderstanding of what a “whole systemsapproach” could look like acrossBedfordshire.

Establish agreements for improveddata sharing across multipleagencies throughout Bedfordshire,including between BedfordshirePolice, local Hospitals and theAmbulance Service.

Please note that these are just 10 of the 35 recommendations listed in the full document.

Undertake 1:1 interviews andstakeholder engagement event(s) todiscuss findings from this rapid SNA,and explore priorities, especially"unmet" need across key stakeholdergroups in more depth (phase 2).

Work with academic partners andPublic Health England tounderstand the protective factorsassociated with specific types ofviolence and exploitation.