Decision details

Adults with Complex Needs

Decision Maker: Co-operative Executive

Decision status: Recommendations Approved

Is Key decision?: Yes

Purpose:

This report will outline options for how we support adults in Sheffield with a range of support needs, including homelessness, substance misuse and mental health needs.

Decision:

8.1

The Executive Directors, People Services and Place, submitted a joint report describing the aims and objectives of the Adults with Complex Needs project, highlighting the positive outcomes that will be achieved for both adults with complex needs and the wider community if it is successful, describing the financial model and associated medium-term savings, and seeking approval for this project.

 

 

8.2

RESOLVED: That Cabinet:-  

 

 

 

(a)

approves the Complex Needs project, including the proposed method of funding using social investment, and outcomes payments of between £100,000 and £200,000 per annum for five years; total outcomes payments of between £500,000 and £1m;

 

 

 

 

(b)

approves the City Council taking the role of lead commissioner for the commissioning of this service, on behalf of, and in consultation with, partner organisations and (where necessary) entering into appropriate agreements for this purpose with those organisations;

 

 

 

 

(c)

delegates authority to the Director of Finance and Commercial Services, in consultation with the Director of Legal and Governance, the Executive Director of People Services, the Executive Director of Place, and the Cabinet Member for Health and Social Care, to approve the Procurement Strategy and Contract Award for the project; and

 

 

 

 

(d)

delegates further decisions about the implementation of this project (insofar as not delegated under the Leader’s Scheme of Delegation) to the Director of Commissioning, Inclusion and Learning, in consultation with the Executive Directors of People Services and Place.

 

 

 

8.3

Reasons for Decision

 

 

8.3.1

The option of creating a new service, funded through a social investment model, is preferred for a number of reasons:

 

If successful, the service will result in a reduction in behaviour that is disruptive for the community, whilst also support a cohort of complex adults to achieve improved outcomes. These outcomes are:

   

     Adults with Severe and Multiple Disadvantage (SMD):

 

-       An increase in the number of individuals living in safe, secure and appropriate accommodation.

-       Reduction in the number of unplanned hospital admissions amongst the identified cohort.

-       Reduction in involvement in crime and anti-social behaviour amongst the identified cohort.

-       Improvement in wellbeing.

 

     Adults with SMD and a particular alcohol need:

 

-       A reduction in the number of unplanned alcohol-related admissions to the Northern General Hospital amongst the identified cohort.

-       A reduction in the number of re-admissions within 30 days amongst the identified cohort.

-       The new service will be established without requiring any immediate disinvestment from current provision (effectively allowing ‘double running’ for a number of years).

-       If successful, this approach will result in a net saving to the public purse of £3m - £3.7m over the lifetime of the project (net of outcomes payments to be made to repay the up-front social investment).

 

 

8.3.2

The new service will be established without requiring any immediate disinvestment from current provision (effectively allowing ‘double running’ for a number of years).

 

 

8.3.3

If successful, it is expected that this approach will result in a net saving to the public purse.

 

 

8.4

Alternatives Considered and Rejected

 

 

8.4.1

Social investment is a relatively new tool that is available to local authorities to help fund new services where there is a demonstrable positive impact on outcomes from the intervention. However, it is not a panacea, and for some issues there are better ways of investing in new service models. 

 

 

8.4.2

In this case, the option of delivering this project through a traditional fee for service model, funded up-front through public sector budgets, has been considered. For the SMD cohort, resources have been secured to establish a nine month pilot multi-agency team in order to test out this method of delivery. However, getting this in place has been, and remains, challenging and illustrates the challenge of getting upfront resource, particularly for the medium-term. The agreement with commissioners and providers is that this is only a short term pilot and at the end of the pilot period staff would return to their substantive roles. As this has been achieved by re-allocating current resources, no alternative funding methods have been made available, or have been identified, for the long term funding of a multi-agency team.

 

 

8.4.3

If no intervention is put in place for this cohort, it’s expected that these cohorts will continue to access services in an ad hoc and unplanned way, continue to have poor outcomes, and their support needs will continue to manifest in ways that are disruptive to people around them, such as aggressive or passive street begging, public drinking and associated anti-social behaviour, and use of Spice.

 

 

8.5

Any Interest Declared or Dispensation Granted

 

 

 

None

 

 

8.6

Reason for Exemption if Public/Press Excluded During Consideration

 

 

 

None

 

 

8.7

Respective Directors Responsible for Implementation

 

 

 

Jayne Ludlam, Executive Director, People Services and Laraine Manley, Place

 

 

8.8

Relevant Scrutiny and Policy Development Committee If Decision Called In

 

 

 

Safer and Stronger Communities

 

 

 

Report author: Emma Shepherd

Publication date: 24/07/2018

Date of decision: 18/07/2018

Decided at meeting: 18/07/2018 - Co-operative Executive

Effective from: 31/07/2018

Accompanying Documents: