Halfway to the holy grail?

In this column I want to continue a theme of what local government can do for you. I have long argued that for localism to be real it has to be based on a vision of what you want your area to achieve.

In Salford we have to find a way of supporting people out of poverty and into real engagement with the rest of society. One such way is by working with all organisations to provide a unified approach to vulnerable people.

For local authorities in the country’s most deprived areas, this economic climate presents the starkest of challenges: how can we stay on mission in tackling disadvantage with the funding reductions which have hit our areas hardest?

I believe our first responsibility is to ensure that people do not become further disengaged from the social and economic mainstream. This is a nightmare scenario for places like Salford, where we have worked so hard to pick up the pieces of previous recessions and started to provide real economic opportunity and raise aspirations amongst young people.

Of course, the wider context of this challenge is welfare policy that will deliver more ‘stick’ than before, and an economy that is not yet providing many opportunities to connect people to.

It seems the ‘holy grail’ we are all looking for is a scalable way to deliver better outcomes with people and places that drain the public purse – the ultimate ‘win-win’.

‘Joined up solutions’ is not a new idea, and we have made much progress in our partnership and neighbourhood work, but we must accept that this has not delivered the reform of mainstream services required. Now the rules of the game have changed, calling for more focus on pooling resources as the route to tackling disadvantage, delivering more personalised, integrated support and reducing demand for costly acute services.

The worst excesses of poverty and the best illustrations of how much we have to change public services can be found in families with multiple needs. This group have become a focus of government policy and community budgets, with promises of ‘barrier busting’ from Whitehall – we’ll need to wait and see on that.

Salford is leading work with so called ‘complex families’. Our first piece of learning is it is public services that are the complex ones! We have uncovered duplication, reactive, expensive responses, multiple assessments, frustration at the front line and a cycle of poor outcomes.

One family had more than 250 interventions from different agencies in the course of a year. This had many public services on the back foot. For the police: 58 call-outs to the property, five arrests, 109 officer hours. Health: five emergency ambulance call-outs and visits to A&E, hospital stays for two family members. Housing: two injunctions taken out against family members, repeated complaints from neighbours about antisocial behaviour, calls for re-housing. Council: inputs from the youth offending service, issues with arrears. There are also the costs of welfare benefits, and other services who were responding to this chaotic situation. The annual cost of this family to public services was over £200k.

Our work has delivered an integrated solution, with a single case worker and a joint agency focus on prevention and early intervention. Outcomes have dramatically improved and the annual costs are estimated to reduce by two thirds.

This is not an initiative, but a whole system change. We are scaling the model up and rolling it out across the city’s most deprived areas. This is being supported by reforms to commissioning, engagement, intelligence and a focus on workforce development. The systems that drive silo based working have to change to empower the front line.

This approach presents a major challenge for politicians, officers and communities – but one that can provide real purpose and direction to the business of reducing duplication and sharing services.

We don’t claim to have found the holy grail, but we think this work may be among our best chances to advance Salford’s social and economic fortunes while balancing the books.