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Tagged In:  Substance Misuse

As we are fast approaching announcements regarding the government’s spending review, which is scheduled for 25th November 2015, we take a look at what the Institute for Public Policy Research (IPPR) is recommending to help people with complex and multiple needs.

In its final budget statement of 2015, the Coalition government committed to undertaking a review of how to reduce over £4bn spent on ‘troubled individuals’ who struggle with homelessness, addiction and mental health issues, before the next spending review. It’s our understanding that the Conservative government is now looking at ways of extending the Troubled Families programme to those with complex and multiple needs ahead of next month’s announcement. 

Certainly, the IPPR’s research findings and recommendations will inform whatever decisions the government takes. 

Proposed Troubled Live programme

The IPPR recommends a ‘Troubled Lives’ programme, based upon similar principles to that of the Troubled Families programme in social care. Its paper states ‘Troubled Lives would be targeted at approximately a quarter of a million individuals who experience two or more of the following problems: homelessness, substance misuse and reoffending’, in much the same way as Troubled Families has reported to have helped a targeted 120,000 families.
It’s envisaged that this approach would help improve the lives of some of the most vulnerable and excluded people and that the success would not be linked to individual outcomes, but to area-level outcomes with local authorities showing the direct impact on how the programme lowers the demand on crisis care services after one year of the programme. 

The IPPR states that since services are set up to address single issues, such as substance misuse, homelessness or mental health, ‘rather than addressing the various needs of the individual, multiple professionals are often working with the same person’. 

How do we know that complex needs overlap?

There’s been plenty of discussion around how those with complex needs face a number of issues; most notably homelessness, substance misuse and offending, but until now there’s not been a study that really explains why people face persistent difficulties. 

In making its recommendations, the IPPR refers to new evidence commissioned by the Lankelly Chase Foundation from researchers at Heriot-Watt University (Bramley and Fitzpatrick 2015). They looked at those who have been through the criminal justice system, those who have received substance misuse and homelessness support. Their evidence shows that over half a million people are using one or more of the services, and that 58,000 are repeat users of all three. They also found that those offenders experiencing all three issues are at greater risk of reoffending than those just experiencing one or two issues, which will come as no surprise to probation officers. 

A decentralised approach

The recommendations are that if the lives of adults with complex needs are to be addressed, a decentralised approach needs to be taken, as opposed to large-scale national programmes. National priorities, the IPPR argues, should be set by central government, but local responsibility and accountability should be local, with person-centred support being the core focus. 

The paper calls for the government to prioritise adult multiple and complex needs in the spending review, to help 250,000 people experiencing at least two of the following; homelessness, substance misuse and offending. 

Whether the government will prioritise the IPPR’s recommendations in its spending review is anyone’s guess though. After all, the IPPR has estimated that a Troubled Families fund would need an investment of £100m each year over a period of four years, with funding to be matched from locally pooled budgets. 

The paper also calls for probation funding to be given consideration too given the high levels of spending on prison for those with complex needs. However, since the budgets for those serving less than 12 months are tied-up in CRC contracts as part of the Transforming Rehabilitation reforms, it’s unlikely that any funding will be made available from probation, although co-commissioning partnerships might well be established in some areas if the proposals are given the green light. 

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