Revolving Doors Agency

• Our mission is to change systems and improve services for people with multiple problems, including poor mental health, who are in contact with the criminal justice system.

• We demonstrate and share evidence of effective interventions and promote reform of public services through partnerships with political leaders, policy makers, commissioners, service providers and other experts. We involving people with direct

experience of the problem in all our work.

1

Lambeth Community Safety Partnership (LB Lambeth) –Action research developing a theory of change across three IOM services in the borough involving commissioners, providers and service users.

Offender Health Collaborative (NHS England) – partnership supporting roll out of liaison and diversion services.

Commissioning Together (City Bridge Trust) – working in LB Wandsworth and LB Barking & Dagenham to involve service users in shaping local services.

Tri-borough Reoffending service (LB Westminster / Tri-borough) Providing critical friend review of new reducing reoffending service.

Examples of current projects

Presentation

• Focus on 2 recent reports– Outcomes that matter to people with direct experience of the issues

themselves

– Payment by result approaches for people with multiple and complex needs

3

10 principles for effective complex needs services

• ‘Someone on your side’: Opportunity to build consistent, positive and trusting relationships.• Assertive and persistent: An approach to engagement that does not give up on people.

Continuous and consistent support over a prolonged period, responding constructively to setbacks.

• Tailored: A personalised approach which addresses the full gambit of an individuals’ needs and is culturally sensitive to particular needs of specific groups

• Building on strengths: Supports the client to recognise and develop personal strengths, recognising more than a ‘bundle of needs and problems’.

• Coordinated and seamless: Understands and links with other services, helps clients to access and coordinate support through brokerage and advocacy, including across key transitions.

• Flexible and responsive: Flexible approach to support and an ability to react quickly in a crisis.

• ‘No wrong door’: If a service cannot provide support, they take responsibility for connecting the client with someone who can.

• Trauma informed: Understands the emotional and behavioural impact of traumatic childhood and life experiences on clients, avoids re-traumatisation, builds resilience and supports recovery.

• Coproduced: Designed in partnership with service users.• Strategically supported: Has the buy-in of senior, strategic stakeholders.

4

5

Good Life Findings• Stability and a life without struggle

– “I just wanna be comfortable. I'm not a breadhead, I haven’t got sky high ambitions ”

• A home– “Basically, for me, what I would like is a place of my own, a sanctuary”

– “It’s not just a roof over your head, with me it’s about having my own little space”

• Being healthy

• Employment

• Financial security– “what would be a good life to me is just being able to earn enough

that I pay my rent and just pay my bills and just be comfortable”

6

Good Life Findings• Relationships

“I think the most important thing is how my children will view me”

• Independence and self-sufficiency

• Fun and enjoyment

• Making a positive contribution“I’ve been there and I wouldn’t like to be there again...If I can help people and mentor people, If I can help them to not go down that way I went”

• Being trusted, respected and valued– “But just to be trusted with other people’s kids, that’s really

important to me”

7

Good life implications for services, commissioners and policy makers

• Stability and meeting basic needs

• Understanding the journey

• Looking beyond traditional service provision

• Quality matters

• Involving service users in defining success

• Personal benefits of service user involvement

8

Adding Value? Commissioning for outcomesExperience

• Chaotic lives

• Multiple and interrelated problems at once

• Exclusion from mainstream services, but high use of emergency and criminal justice services

• Social exclusion, and poor or non-existent family ties

• Economic exclusion and poverty

• Multiple relapses in recovery.

Challenges for PBR

• Defining outcomes or ‘results’, and keeping outcome metrics simple

• Supporting long-term recovery

• Attributing cause to a particular intervention

9

Addressing these challenges

• Using multiple outcomes - Troubled Families & London rough sleeping SIB

• Co-designing outcomes - Supporting People pilots and some of the Drug and Alcohol pilots

• Long-term investment for recovery – Big Lottery

• Appropriate pricing and resourcing

• Quality –including user satisfaction as part of the outcome framework

• Joint commissioning and pooled budgets – London Tri-borough pilot

10

Tri-borough ‘Whole Place Community Budget’

• “if the outcomes [of a PbR scheme] are affected by other public, private, or voluntary services, then those bodies may need to be joint commissioners” - Audit Commission

• Potential to reinvest savings from reduced demand, taking a ‘whole system’ view and monitoring demand on other services to help make the case for shifting funds into community based preventative work.

• Cross-departmental agreed Financial model

• Tri-borough: Previously, different agencies were spending around £6 million on nine different reducing reoffending programmes, with reconviction rates still rising. Moved to coordinated funding of a service aiming to provide personalised, comprehensive, through-the-gate support for short-sentenced prisoners:

11

Recommendations 1. Setting outcomes that incentivise a holistic, person-

centred approach.

2. Ensuring outcome measurements and targets reflect the need for longer-term, flexible interventions supporting the recovery journey.

3. Setting payment structures that support investment in an intensive, assertive approach, and prevent ‘parking’ and ‘creaming.’

4. Promoting a joined-up approach.

5. Considering alternatives to PbR.

12

Thank you

vicki.helyar-cardwell@revolving-doors.org.uk

http://www.revolving-doors.org.uk/home/

@RevDoors

13