Cabinet Office Social Exclusion Taskforce

Next steps in tackling social exclusion – 12 approaches to tackle the country's most chronically excluded adults

18 June 2007
CAB/054/07

Today the Government announces the next steps in its programme to tackle social exclusion, supporting twelve new projects to help the most chronically excluded adults in society.

Since the launch of the Social Exclusion Action Plan in September last year the government has argued that specific approaches are needed to tackle social exclusion. Established and successful policies to tackle wider poverty such as the minimum wage, the New Deals and tax credits have helped the majority move from welfare into work.

However, figures from the charity, ‘Revolving Doors’ show there are approximately 66,000 adults in the UK facing multiple and complex issues that require specialised interventions and support. Though a minority of the population, they often lead lives damaging to themselves and in some cases to those around them. In addition they can cost thousands of pounds in service provision because they bounce from service to service, often not receiving the tailored help they need.

The multiple problems they face can cross several agencies at one time and can involve issues such as childhood abuse, addictions mental health problems and homelessness. Consequently, this minority can slip through the net.

Today's announcement is part of the Government's birth to adult approach to social exclusion and comes only a few months after an early intervention programme aimed at the early months and years of children's lives was introduced. ‘Family Nurse Partnerships’ are already underway, supporting the most vulnerable young mums-to-be and their babies.

Social Exclusion Minister Pat McFadden is visiting the charity Thames Reach today in London, one of the schemes taking part in this 3-year programme. He believes it's time for a new approach to helping such vulnerable individuals, and said:

‘When adults experience such extreme difficulties in their own lives, there is a huge impact on them, services and everyone around them.

‘Sometimes the individual services do a perfectly good job dealing with the specific issues, but the piece that's missing is someone to look at the person's problems in the round. Dealing with these multiple issues service by service can be a bit like looking at a series of snapshots instead of at the whole film.

‘We need to ensure the systems in place to help people are working together better. The Pilot projects we are supporting today are designed to help people get their lives on a more positive track’

Jeremy Swain, Chief Executive of Thames Reach, said:

‘We are impressed at the Government's commitment to not giving up on the most excluded people in our society and delighted to have the opportunity of working in partnership with the Social Exclusion Task Force to rebuild shattered lives.’

Adults facing Chronic Exclusion will often experience:

• Poor health prospects – mental and/or physical health issues
• A history of exclusion, institutionalisation or abuse
• Behaviour and control difficulties
• Skills deficit – unemployment and poor educational achievement
• Addictions

A total of £6million will be shared between the 12 successful projects over the next three years.

Innovations from these projects selected by Cabinet Office include offering outreach services to support rough sleepers and long term unemployed as well as employing staff who are former service users to run the projects.

The announcement today is the next step in a series of actions to come out of the Social Exclusion Action Plan launched last year. Also published today is the first part of a major review into families at risk, announced by Cabinet Minister for Social Exclusion Hilary Armstrong in March. It will clearly show the dramatic impact that parent-based family circumstances have on the outcomes and life-chances of children, and demands a more family-focused approach from agencies that work with adults and those that work with children.

Today Hilary Armstrong will be updating key partners on the analysis and themes in the report. For a copy of the report go to www.cabinetoffice.gov.uk

ENDS

Notes to editors

Adults Facing Chronic Exclusion (ACE) Pilots

The programme is a cross–government collaboration with four departments sponsoring the programme: Home Office, Communities and Local Government, Department of Health, Department for Work and Pensions. The Cabinet Office is leading the pilots in partnership with voluntary and community sectors, local authorities and health authorities.

A full list of the successful ACE pilots are detailed below or you can visit www.cabinetoffice.gov.uk for more information.

The cost of not tackling social exclusion is highlighted in writer Malcolm Gladwell's “Million Dollar Murray” which describes the financial cost of not acting to find solutions to chronically excluded adults problems.

Families at Risk review (FARR)

The  Families at Risk Review was launched in March.

Summaries of successful ACE Pilot programes

Fairbridge (South West / Bristol)

The Fairbridge ACE Project will provide a replicable model of evidence-based support to prevent chronic exclusion for adults at risk, particularly those at key transition points. It seeks to demonstrate the cost effectiveness of investing in interventions which build resilience through developing protective factors.

The project will create personalised interventions using five clear phases: Engagement, Diagnosis, Stabilisation, Development of Protective Factors and Progression. More specifically, the project will develop and test a range of replicable, experiential learning modules designed to achieve outcomes specified by a framework which reflects the objectives of this prospectus. Ongoing support will be provided by key workers to enable individuals to diagnose specific needs, identify the most appropriate modules to address them, and sustain engagement and progression. These key workers will also help participants access other appropriate specialist services. The outcomes will be fed back to the local authority to inform future commissioning.

For more information, please contact 
Jenie Butterworth
0207 902 1106

NOAH (East of England/Luton)

The aim of the project is to be proactive in finding people in acute need in Luton and to be proactive and supportive in engaging them in a range of holistic support that will help them to improve their life situation before they are in crisis. In doing this the project will look at the best way of working to eliminate the revolving door of provision of expensive statutory emergency help which is frequently followed, and therefore frustrated, by return to the vulnerable circumstances which gave rise to the crisis.

A number of agencies are involved in the current process, primarily the PCT, Mental Health Partnership Trust, Luton Drug & Alcohol Partnership, local authority and the emergency services. The cost of what is often repetitive emergency intervention is considerable and lasting beneficial outcomes for the individuals concerned are not being realised. The aim will be to dramatically improve these outcomes.

For more information, please contact 
Jim O'Connor
01582 728 416

St Mungos (London)

Efforts to work successfully with this group have been undermined by the clients' inability to form and sustain relationships, their difficulty with engagement, and their hostile transferences towards ‘authority’ figures. The great majority of chronically excluded adults have deeply damaged, disorganised attachment patterns. Unless these patterns of relating change, then poor outcomes remain inevitable. The techniques of Testimony and Narrative, supported by psychotherapy, have shown themselves effective change agents with such damaged individuals such as victims of torture or disturbed adolescents. There are good reasons why a variation of these techniques will work with ‘chaotic’ adults, enabling them to make positive engagements.

Outcomes will include: reduced substance dependency, more successful resettlement, increased take-up of other services, reduced offending and antisocial behaviours. The project anticipates effecting lifelong change in the individuals involved. The aim of the ‘Lifestory Project’ is therefore to enable social inclusion for the most socially excluded.

For more information, please contact 
Peter Cockersell
07714 699 634

Thames Reach (London)

The pilot will work with floating support schemes in the London Boroughs of Southwark and Lewisham, to reintroduce adults facing chronic exclusion to employment. The experience of working with this group is that they have little recent positive experience of work.

Given the prolonged worklessness of the group, the move back to work will not be straightforward. It may involve periods of unstable employment and of renewed unemployment should participants lose work. The pilot will support participants through this period of transition with motivational support, specialist advice, and a financial safety net to remove barriers to work, and protect participants from the negative aspects of the transition to work. It is anticipated that the pilot will generate significant long term savings to the exchequer by helping this group become economically active.

For more information, please contact 
Bill Tidham
020 7702 5630

Turning Point (North West/Bolton)

The proposal is to conduct Connected Care audits in three of the most deprived areas in Bolton and to set up services based on these audits. Connected Care is a new approach to service delivery, integrating health and social care, as well as housing, employment and community safety, to provide targeted support for people with complex needs in deprived communities. The approach champions the provision of joined up, bespoke services, which address the full range of individuals needs, providing a single point of entry and navigation through services. The key milestones of the pilot will be the development of a resource audit; a connected care audit, profiling the level and breadth of needs within the community; and a cost benefits realisation exercise. These will feed into the development of a service specification for Connected Care services, providing a service model that can be evaluated against the outcomes framework and replicated nationally.

For more information, please contact
Richard Kramer
020 7481 7651

Tyneside Cyrenians (North East/Newcastle)

Based in central Newcastle, this pilot project will use day and night outreach to seek out chronically excluded individuals including rough sleepers, sex workers, prolific offenders, and those with drugs, alcohol and mental heath problems enabling them to access an entire system of integrated support on one site through a non-threatening single point of entry.

The unique feature of this pilot is that all those who will be employed on the project will be ex-service users. Building on the lessons learned from Trading Places, an award winning peer support project operating from the Day Service, it is known that those who have themselves experienced chronic exclusion are the people with whom the target group are most likely to engage and are also excellent role models. They are knowledgeable and passionate about the many indefinable barriers to accessing services and possess empathy and insight into how to make contact and initiate change.

For more information, please contact 
Neil Baird (Communications and Fundraising Manager)
0191 273 8891

Milton Keynes BC (South East)

A group of high needs people has been identified in Milton Keynes who struggle to access or engage with services and whose needs are therefore unmet. The resulting levels of personal chaos put them at considerable risk of offending. The pilot will bring together an enhanced menu of cross-systemic interventions to tackle this problem:

1. Link Workers will access and engage clients presenting across all crisis services.
2. A devolved budget will be used to overcome obstacles to the delivery of a responsive and effective service.
3. A multi-agency partnership group will be tasked with affecting wider system reform based on the feedback and evidence from the service.
4. This panel will be advised by a service user advisory group on the allocation of a system improvement budget to help fill gaps in provision.
5. A system of community volunteer mentoring will extend the reach of the project and build community cohesion.

Learning from the project will be formalised into a toolkit to aid national replication.

For more information, please contact 
Richard Solly
01908 254 429

South West London & St. George’s Mental Health NHS Trust (London)

This project aims to prevent the vicious cycle of exclusion by early identification of people experiencing difficulties. The team will intervene early focusing on Merton residents not engaging in services, resulting in multiple exclusion, chaotic lifestyles and negative social outcomes for themselves, families and communities. Specific aims are:

1. Collaborative agency working; agree local ‘chaos index’ identify individuals or groups to target.
2. Develop integrated pathways moving clients from at risk stages (e.g prison release, repeat offending, discharge from NHS treatment, non-engagement in services, accommodation problems etc) to more structured engagement in services resulting in stable accommodation and employment or mainstream education/training.
3. Establish a New Directions Team (NDT) to intensively case manage individuals and assist them to navigate mainstream services.
4. Multi-agency steering group for NDT, to ‘flex’ existing systems/eligibility criteria; enable systems change facilitating engagement in mainstream services.
5. Monitor NDT against agreed outcomes framework that incorporates individuals, families and services 

For more information, please contact 
Mark Clenaghan
020 8682 6636

After Adoption (North West)

This pilot will work with some of the most excluded parents in the prison system and continue in the community where they are at risk of losing or have lost their children to adoption. By using an evidence based approach it will:

1. Reduce the number of parents from the target group that have subsequent children taken from their care and thus help break cyclical patterns of disadvantage;
2. Promote healthy, positive relationships within families;
3. Promote positive coping mechanisms to the target group with a view to reducing the prevalence of addictions;
4. Rehabilitate the target group into the community and help forge positive, accessible networks to help break negative patterns of behaviour;
5. Improve the level of active participation in society of the target group (training, employment, community opportunities taken up).

Calderdale Domestic Violence Forum (York & Humber)

The pilot will identify those women who are experiencing chronic social exclusion as a direct result of domestic violence. Using a Multi Agency Risk Assessment Conference to identify those at risk, the pilot will focus on the most serious and chronic domestic violence cases and provide the earliest possible interventions and support to women and their children.

The pilot will develop a Common Assessment Framework and bring together a multi agency team of health, social care, criminal justice and third sector professionals in order to develop an integrated approach and response to victims and perpetrators. The pilot will address the complex issues such as homelessness, substance misuse, child protection concerns, debt and finance, mental health, rape and sexual assault which are often manifestations of domestic violence.

Counselling in Prison and HMP Holloway

Summary of the pilot:

• To effect the recommendations of the Corston Report (2007) by developing a prison without walls counselling and psychotherapy programme. The model is a novel, integrated partnership approach to women's health in custody.
• Counselling in Prison and HMP Holloway will provide group therapy to women prisoners.
• The interventions will be modular and aim to increase; life skills, emotional literacy, individual autonomy, self esteem and confidence.
• Interventions will be offence focussed and aim to reduce self harm, re-offending and protect the public.
• Transition from prison will be eased by 1:1 therapy commencing prior to release. This will continue with the same therapist, for up to one year post release, in a unique “through the gate” follow on programme.
• Group and 1:1 interventions will be delivered by qualified clinicians and CiP's honorary practitioners in a new partnership developed for the programme.
• Training for prison officers will effect a cultural shift in managing difficult women in custody.
• Practitioners will facilitate women's access to external agencies.
• A research post attached to the project will evaluate outcomes.

For more information, please contact
Steve Morris
0797 066 8213

MCCH Autism

The project will improve the ability of adults with learning disabilities, autism or mental health problems to access, for example, housing, social and health care, learning, employment, leisure and financial services, focusing on people who experience chronic exclusion, as well as those with histories of ‘bouncing’ in and out of services. A special focus will be those adults with autism and Asperger syndrome, often undiagnosed, neglected, and ineligible for services or referred by default to services such as learning disability or mental health. The pilot will engage service users, commissioners and providers of services in developing better outcomes, through individual support, equipping adults through person centred plans, mentoring and advocacy to find and sustain their way through services. Project partners are keen to support individuals in accessing individual budgets and self determined services. Stakeholders will identify and document successful models of intervention for long term dissemination and development.

Tel: 020 7276 1191/1203
Fax: 020 7276 0618

www.cabinetoffice.gov.uk

Out of hours telephone 07699 113300 and ask for pager number 721338