Supporting People Local Financial Benefits Model South East London Tom Ashton 17 December 2009

Objectives / expectations The objectives of this session are to: Explain the Supporting People National Benefits Model and the work we’ve carried out to update it build a local model pilot that local benefits model Explain the context for the local model Demonstrate the local model Explain how the user guide works Answer any questions Are there any other expectations we need to meet in this session?

Agenda / Contents Introduction to / re-cap of the Supporting People National Benefits Model Detail of the recent project Updating the work Adding new client groups Developing a local model The local model Context & where to find it Demonstration and user guide Expectation review & questions Our contact details

Introduction to / recap of the Supporting People Financial Benefits Model

We start by explaining how the national model works... The national model, for each of a set of client groups, compares the cost of: existing arrangements (involving Supporting People) an alternative provision scenario. The alternative provision scenario for each client group was built on the assumption that, in a world without SP, current clients would get a mix of: existing arrangements, with the SP-funded element removed alternative residential care arrangements (e.g. nursing care, psychiatric care, rehab etc.)

...it includes the use of two kinds of costing Costs of existing arrangements and the alternative scenario include ‘Package costs’: These are the costs associated with providing support (e.g. SP services, Housing costs, Living costs, Social services costs, Benefits administration) ‘Event costs’: These are the costs associated with events that happen to clients (either positive, planned interventions or adverse events e.g. Health interventions, Costs associated with committing or become a victim of crime, Costs associated with becoming homeless (rough sleeping, tenancy failure etc.)).

x 31,238 = £1.29bn £39,010 £2,327 £41,337 National Model Example: Learning Disabilities (1) For the 31,238 SP supported households containing people with learning disabilities, the two scenarios were: The existing arrangement: 100% (31,238): existing arrangement 65% (20,305): residential care 35% (10,933): existing without SP An alternative arrangement: Package cost (per household unit): Event cost (per household unit): Total cost (per household unit): Package cost (per household unit): Event cost (per household unit): Total cost (per household unit): £79,133 £2,327 £81,460 £27,185 £4,697 £31,882 x 20,305 = £1.65bnx 10,933 = £349m=£2.00bn +

x 31,238 = £1.29bn £39,010 £2,327 £41,337 National Model Example: Learning Disabilities (2) The net financial benefit is £711m: £2.00bn - £1.29bn = £711m. 100% (31,238): existing arrangement 65% (20,305): residential care 35% (10,933): existing without SP An alternative arrangement: Package cost (per household unit): Event cost (per household unit): Total cost (per household unit): Package cost (per household unit): Event cost (per household unit): Total cost (per household unit): £79,133 £2,327 £81,460 £27,185 £4,697 £31,882 x 20,305 = £1.65bnx 10,933 = £349m=£2.00bn +

National Model Example: Learning Disabilities (3) Event type Cost per annum (with SP or residential care) Cost per annum (without SP or residential care) Additional cost (without SP or residential care) Being admitted to hospital due to general health issue £1,537£3,236£1,699 Visiting an A&E department £351£369£18 Being admitted to an acute mental health ward £23£47£25 Visiting a GP due to general health issue £237£249£12 Visiting a community health service (not mental) £82£87£5 Being visited by a community mental health nurse £8 £0 Being a victim of burglary £31£32£2 Being a victim of street crime (violent crime or mugging) £59£62£3 Becoming a victim of homelessness £0£178 Receiving home care provision £0£428 Total £2,327£4,697£2,370 Event costs: the point to note is that event costs are much higher for people who don’t receive SP support or residential care. Some key events drive this situation…

Similar work was done for other client groups, producing a total benefit Remember that the client groups are of different sizes Note also that coverage doesn’t include all client groups Client groupCost (£m)Net financial benefit (£m) People with Alcohol Problems(20.7)92.0 Women at Risk of Domestic Violence(68.8)186.9 People with Drug Problems(30.1)157.8 Homeless Families with support needs - Settled Accommodation(32.5)(0.5) Homeless Families with support needs - Temporary Accommodation(17.5)28.5 Single Homeless with support needs - Settled Accommodation(130.1)30.7 Single Homeless with support needs - Temporary Accommodation(106.7)97.0 People with Learning Disabilities(369.4)711.3 People with Mental Health Problems(254.4)559.7 Offenders or People at risk of Offending, & Mentally Disordered Offenders(55.4)40.3 Older People in Sheltered Accommodation(198.2)646.9 Older People in Very sheltered Accommodation(32.4)123.4 Older People receiving Floating Support and Other older people(97.3)628.0 People with a Physical or Sensory Disability(28.4)73.3 Teenage Parents(24.9)(18.3) Young People at Risk - Settled Accommodation(94.9)26.6 Young People at Risk - Temporary Accommodation(38.1)26.7 Young People Leaving Care(12.7)(0.7) Total(1,612.4) 3,409.4

The recent work with CLG (Feb – June 2009)

We carried out three tasks in our recent work with CLG Updating the data in the national model Adding new client groups Converting to a local model

The National Updating was primarily a matter of housekeeping Every data source that was cross-referenced in the original model was checked, and was updated if the source had been updated The cost indexation (which uses the RPI) was adjusted to bring all costs forward to 2009 levels Other minor adjustments were made, including an adjustment to our treatment of the groups of older people to group those categorised as “other” (primarily people receiving community alarms or Home Improvement Agency services) We adjusted our estimates of package costs, since discussion with Hilary Bartle – and independent consultant who had previously been deputy programme director – suggested that they had been under-estimated in the original work The updating of the national model drove modelled benefits up from £2.77bn to £3.41bn. A number of factors drove this, although a key one was inflation in the cost of escalated interventions (residential care etc)

We added the following client groups People with alcohol problems Teenage parents Young people leaving care People with physical or sensory disabilities Together with the client groups already covered, described in the previous section, this coverage to 93% of Supporting People spend nationally. Some client groups remain un-modelled – these are the smaller groups: People with HIV/AIDS, Rough sleepers, Refugees, Travellers & a generic client group

The Local Authority work had three key strands The three strands were 1.Engaging through stakeholder meetings in London 2.Engaging through regional group meetings 3.Piloting Engaging through a stakeholder meeting in London (31 March) produced agreement on the best approach to a local model, and follow up meetings were held in May Regional group meetings were also used to inform people of progress The model was piloted in early May with Hampshire County Council, Middlesbrough Council & Leicester City Council These figures are based on 2004/5 SPLS data We are now returning to Regional Groups to publicise the model

We considered a number of options, and selected one of them with local authorities Client numbers Package costs Client numbers Package costs Alternative scenario composition Client numbers Package costs Event reductions from SP Alternative scenario composition Option 1Option 2Option 3Option 4 Data that can be edited in local model Using one option has the advantage that it produces consistency of output. This is our preferred option; it allows for local variation but avoids asking people to make judgements that may be difficult to make at local level. Option 2 is what has been implemented.

The Local Model

The Supporting People Financial Benefits Model is published on CLG’s website There are two links: A report on the national model can be found at ch The local modelling work – together with a user guide can be found at

The first point of context is that local modelling has “offensive” and “defensive” purposes The “offensive” purpose is to allow Authorities to see what they are gaining from using Supporting People services The “defensive” purpose is to allow them to defend these costs to other stakeholders To some extent there has to be an assumption that benefits locally are similar to benefits for the national picture The exact level of benefits that Authorities gain from Supporting People services will depend on their efficiency & their quality of delivery. It is not in the scope of the modelling to support judgements about that.

20 In terms of “offensive” modelling the context is as follows

We will demonstrate the local model We will imagine ourselves to be representatives of Birmingham City Council – and we will edit relevant parts of the model

The documentation for the local model is similar to the pre-existing documentation The model documentation breaks down into six key sections: 1. Summary 2. Model purpose and logical structure 3. Quick start guide 4. The spreadsheet 5. Glossary 6. Technical appendix 5 pages that explain in outline how the model works 10 pages that explain how to use the model 20 pages that explain how the model works in full Glossary that includes detail of how the modelled client groups are constructed National documentation was also updated for CLG to use

Questions Expectation review AOB

Our contact information

Contact details Hilary BartleIndependent Consultant, Hilary Bartle Consultancy Peter BecqueOperational Research Consultants, Capgemini m/services/consulting/or Tom Claire Hempenstall