Agenda item

The Changing Futures Programme in Leicester has been running operationally since September 2022.  In the two years of operational delivery, support has been provided to 162 people facing multiple disadvantages. This presentation will demonstrate the outcomes of this support with a specific focus on health outcomes.

The Changing Futures Programme Manager presented the report to update the Board on the outcomes from the programme since it began running operationally 2 years ago. It was noted that:

• The programme was lottery funded.
• Between September 2022 and August 2024, 162 individuals had been supported. Currently, 36 individuals were supported.
• The team was multi-disciplinary. There were 6 intensive support workers, 2 police officers, substance use treatment worker, team manager and administrator, data analyst and the programme manager.
• The programme had worked closely with the voluntary sector and other partners.
• The team had done outreach work with Dear Albert, Turning Point and other partners to highlight the different services that were available. The team had visited areas where there had been a high footfall of street lifestyle behaviours.
• Over 12 months, one individual had 79 emergency department admissions, 65 ambulance call outs, 49 police call outs with an estimated cost of £159,000[DH1] [KW2] . This excluded any costs for other services such as housing or Turning Point. This cost could be prevented through intensive support offers.
• The individuals were generally aged 25-50 and had been subjected to multiple disadvantages. The majority had been reliant on drugs or alcohol, and most had a suspected or diagnosed mental health condition and many were homeless.
• Many of the women had engaged in sex work.
• 87% of support was successful. By the end of the support, the majority were in some form of accommodation.
• These individuals had been referred as they were failing to engage with services.
• The programme worked with prison leavers by engaging them while they were still in prison in order to build a relationship before release.
• The programme was part of a steering group for prison leavers.
• It had taken part in a pilot to reduce repeat presentation at the Emergency Department by supporting individuals to use GP services or alternatives.
• 19 individuals had been supported to attend appointments or to book outpatient appointments. The team had been actively seeking out individuals to help them attend appointments if they had not been contactable.
• The team had been liaising with in patients to ensure staff were aware of and planning for the different needs, as traditionally there had been a fear of being an inpatient due to withdrawals. This support helped ensure they were medicated appropriately and had the support needed.
• Often an individual had been referred for something specific like accessing treatment, but when this had been explored there were other factors that needed to be addressed to impact their ability to treat the referral point.

As part of discussions following the presentation, it was noted that:

• The funding had allowed work to occur with a small number of people, but the impact on those most vulnerable had been huge.
• The partnership working had been effective and was positive to see.
• The figures around the cost of contact with ‘the system’ were quite shocking.
• Conversations with the ICB around prison leavers and offenders had led to a team member being placed with them.
• The current funding was ending. Further funding access was being considered due to the positive impact of the programme.
• The goal for the next financial year had been to map the need and to consider what was meant by multi-level disadvantage and what this meant in Leicester.
• This mapping was essential in designing a sustainable model for moving forward to demonstrate the cost effectiveness of the services offered and the savings it made to other areas. If this was achieved in a robust manner it would make a powerful argument for future funding.
• Qualitative and quantitative data was to be gathered over the next quarter.
• The programme had helped address the gap of those faced with financial exclusion, using children’s services, and health needs.
• The programme provided support to make the very first steps for those using the services whether that had been making an appointment, getting on the bus with them, attending an appointment etc.
• Changing Futures intensive support workers were person centred, focused on building rapport with individuals.
• The service had provided an important element that had invested in people’s wellbeing and future potential as well as demonstrating cost effectiveness.

Agreed:

The report was noted.