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Embed code for: Identifying the extent and nature of multiple complex needs in Coventry
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Academic poster presentation to the West Midlands Public Health Excellence Conference on 13 March 2017.
www.coventry.gov.uk/hwbb/ Using anonymised local data from agencies, we were able to add local data to the estimates from Hard Edges, building a better understanding of groups who may be at-risk of MCN. In addition, anonymised row-level local data enabled us to build a picture of the risk factors associated with MCN, for instance, locations/incidents frequently attended by the police; and the risk factors associated with offenders. Finally, anonymised data also allow us to create overlay maps that make visible local levels of need and demand for services. We have mapped data from the police*, fire*, probation*; households affected by welfare reform*; as well as the English indices of deprivation and local life expectancy. This enables the MCN Board and partners to, for the first time, see correlations and patterns in the need and demand for different services. * shown below Si Chun Lam Our starting point was a literature review of existing studies locally and nationally, in particular Hard Edges: mapping severe and multiple disadvantage by LankellyChase Foundation & Heriot-Watt University. Estimates from Hard Edges suggest that Coventry has 6,601 people facing severe and multiple disadvantage at any one point, including… We wanted to go into more detail, and understand the local Coventry population better. To do so, we gathered anonymised data from agencies working across the city to understand the characteristics of people facing MCN and gathered case studies about the lives and experiences of people facing MCN. Supporting People via 1,005 Homeless OASys via 1,393 Offending 1,530 Substance misuse 1,211 Offend+ Subst 457 Homeless+ Subst 297 Homeless+ Offend 891 (SP) SMD3 480 (OA) 6,601 SMD1-3 West Midlands Ambulance Service NHS Foundation Trust Coventry and Rugby Clinical Commissioning Group University Hospital Coventry and Warwickshire NHS Trust 120 (Sep 2016) 7,030 call-outs (Sep 2016) 1,657 (Dec 2016) 150 Aquarius(2016) 2,000 AddAction(2016) 60 older people accessing floating support (2016) 150 Compass(2016) 8,000 CAMHS(2016) 200 16-24 supported accommodation (2016) 100 CAF (Sep 2016) 653 children’s social care contacts (Apr-Sep 2016) 400 accessing tenancy support (2016) 311 statutorily homeless (Apr-Sep 2016) 500 homelessness prevented (Apr-Sep 2016) 1,695 homelessness clients (2015/16, up 25%) Using a range of case studies (children's social care, housing, fire, substance misuse, citizens advice) we are able to map out the lives and experiences of people facing MCN. For example, the timeline below sets out the contacts that a couple had contact with over the period of two years --that is, 24 different agencies. Case studies Characteristics of multiple complex needs Identifying the extent and nature of multiple complex needs in Coventry We adopted a collaborative approach that was iterative (findings feed into work as we go along), minimised reporting (use of visual outputs), data- driven(informed by but not constrained by data), hub-and-spoke (partners undertake/lead different aspects of work), continual sense checking of findings with key stakeholders, and reflective (capturing and sharing experiences). People being supported by NPS Midlands (Coventry) Current cases on OASys end-September 2016 Offending-related needs The most common needs are… needs six category thinking & behaviour 20% 99% Frequency of needs thinking & behaviour 119 lifestyle & associations 103 attitudes 91 relationships 83 alcohol misuse 77 Coventry Multiple Complex Needs n=120 Low 18% Medium 45% High 1% Unknown 36% People being supported by SWM Community Rehabilitation Company Current cases on OASys December 2016 Offending-related risks Risk of serious harm Coventry Multiple Complex Needs n=1,657 OASys General reoffending Predictor Low 29% Medium 17%High 7% Very High 2% Unknown 45% Coventry repeat demand data from West Midlands Police Incidents recorded and police call-outs in September 2016 Frequent callers Coventry Multiple Complex Needs n=7,030 5,372 incidents with phone numbers 52 numbers responsible for fiveor more calls totalling 419 calls 12 numbers responsible for ten or more calls totalling 177 calls 54 calls from four homes 37 calls from the Council 16 calls from the bus garage ⛽ 38 calls about bilkings 28 from homes for children 10 calls from a special school What we did In 2016, Coventry’s health and wellbeing board made improving outcomes for individual facing multiple complex needs one of its three priorities for 2016-19. In addition, troubled individuals became part of the public sector reform programme for the West Midlands Combined Authority. We established a multi- agency multiple complex needs board in Coventry. The board is identifying the extent and nature of MCN in the city and modelling costs and outcomes (research work stream) and looking at how services and support can be redesigned around the needs of people at risk of and/or facing MCN (transformation work stream). Background Individuals facing multiple complex needs (MCN) are people who experience several problems at the same time, often face ineffective contact with services, and live chaotic lives. This can be a combination of offending behaviour/violence, homelessness, substance misuse, mental ill-health, or adverse childhood experiences. What are multiple complex needs? How we did it Despite the disproportionate time and resources spent across different services such as social care, housing and homelessness, police, fire, NHS, criminal justice, probation and substance misuse services, outcomes for people facing MCN are poor. To services, they are a significant source of repeat demand for public services and are amongst the ‘hardest to help’. To improve outcomes for people facing MCN, we need to understand the what, who, where, when, how and why. By understanding the issues, we can manage it better and see the problem through a different lens to achieve a common understanding and a shared solution. The case for change Si Chun Lam · Insight Team · Coventry City Council February 2017 · SiChun.Lam@coventry.gov.uk We now have a range of data about the characteristics of people facing multiple complex needs, and case studies about the lives and experiences of people facing MCN. With this, we have gained a more granular and comprehensive understanding of the lives and experiences of people facing MCN in Coventry. In addition, data and maps enable us to illustrate how risk factors correlate and relate to each other. Our intention now is to combine data and case studies to build stories about the lives and experiences of people facing MCN. We will do so by jointly identifying people, and locations that disproportionate affect our services where a different model could save us all time, money and resources to improve outcomes for this group of people –and use this as a basis for improving the whole system. So what? Next steps… 11/17/14 2/25/15 6/5/15 9/13/15 12/22/15 3/31/16 7/9/16 10/17/16 Sherbourne Fields – Training/Public Evolution 3 –Training/Voluntary Hospital/GP/NHS – Health/Public West Midlands Police –Police/Public West Midlands Fire Service – Fire/Public Foodbank – Food/Voluntary Cyrenians – Housing/Voluntary Valley House – Housing/Voluntary Placements Team – Housing/Public Salvation Army Lifehouse – Housing/Voluntary The Foyer – Housing/Voluntary St Basil – Housing/Voluntary Whitefriars Housing/Caradoc Court – Housing/Public Housing Benefits – Housing/Public Social Care (Children's, Adults, All Ages Disability, MASH, CLDT) – Social/Public Newfield Trust – Money/Voluntary Concentrix – Money/Private Royal Bank of Scotland – Money/Private Severn Trent Water Big Difference Scheme – Money/Voluntary Justice System (Courts) –Money/Public DWP / Job Centre Plus (Benefits including JSA, ESA, IS, PIP) – Money/Public Coventry Law Centre – Advice/Voluntary Grapevine – Advice/Voluntary Citizens Advice Bureau (CAB) – Advice/Voluntary 2014 2016 A G E N C I E S om West Midlands Police Incidents recorded and police call-outs in September 2016 Frequent callers Coventry Multiple Complex Needs n=7,030 5,372 incidents with phone numbers 52 numbers responsible for