Simple but effective: Local solutions for adults facing multiple deprivation (Adults facing Chronic Exclusion evaluation)
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Summary
The Adults facing Chronic Exclusion pilots provide front line services to individuals with complex needs (and which are not conventionally met by statutory services) with the aim of improving local delivery while reducing the total cost of providing support. Each pilot has a different service delivery model; however, all are based on the idea that an effective response to chaos and entrenched deprivation is a consistent, trusted adult who can advocate between local services and service users.
Main findings and implications
The main findings of this report are:
The client group comprised some of the most chaotic or isolated individuals in a local community, who were hard to reach and difficult to engage. The success of the programme should be interpreted in this light.
The work of the pilots was not expensive. Most of the expense was attributable to members of staff working one-to-one with clients or in group work.
The pilot workers often worked as consistent, trusted adults. They worked effectively with the most chaotic and isolated adults to help them navigate the local services and move between transition points in their lives. The pilots were effective in bringing about better outcomes for the individuals, particularly in terms of health.
The consistency of the pilot workers was beneficial to persuading local services to engage with the client group, even in circumstances where clients had been previously denied or not engaged. The pilots were effective at bringing about changes in local service delivery by ensuring that services were open to all.
Although the work of the pilots saw an increase in expenditure on these adults, expenditure was on beneficial services that were good for the clients – health and accommodation – or those that helped to stabilise the client, such as benefits.
It is reasonable to assume that the effectiveness of the pilots will become more obvious as they work with clients over a longer period of time.
These findings demonstrate implications for the pilots, local commissioners and policy makers (see change below) in central and local government. The implications for each are described below.
Pilots need to ensure that their services fit with local priorities and commissioning strategy and that they demonstrate the value of the consistent, trusted adult.
Local commissioners need to recognise that Adults facing Chronic Exclusion clients are entitled to services and benefits and that by allowing these clients to work with consistent, trusted adults, their staff are better supported to provide the service to this difficult group and allow them to access services appropriately.
For policy makers, while there is little evidence that costs are shifting from centrally-funded emergency services to locally-funded health services, it is apparent that these services are being used more appropriately. The Adults facing Chronic Exclusion programmes have demonstrated the value of the consistent, trusted adult that can be applied to move individuals to employment and improved accommodation.