13 November 2018
Cash strapped emergency services are likely to bear the brunt of increased demand from people with multiple and complex needs if statutory services fail to learn the lessons of Birmingham Changing Futures Together’s Lead Worker Peer Mentor service.
Currently funded by the Big Lottery, the Lead Worker Peer Mentor service is proven to improve outcomes for the city’s most vulnerable – people with mental ill health, are homeless or have a history of substance misuse and offending behaviour. It is also proven to deliver potential savings* of over £730,000 per year**. But funding stops in June 2019. Statutory service providers are being urged to learn the lessons and embed the model in their provision before it is too late.
Sophie Wilson, Interim Programmes Director of Birmingham Changing Futures Together explained: “Our purpose is to identify what needs to change to improve the outcomes for people with multiple and complex needs and then support the implementation of that change.
“With funding from the Big Lottery, we’ve proven the value of the Lead Worker Peer Mentor model. We’ve improved outcomes and saved money. Now service providers need to take forward what we’ve learnt and integrate the model into their way of working. If not, the demand from these vulnerable individuals will fall back on our already stretched emergency services.
“We also want national Government departments to take note of the lessons learnt, and integrate the model into the planning, commissioning and funding of services.”
With deeply entrenched behaviour, people with multiple and complex needs (homelessness, offending behaviour, substance misuse and mental health) are amongst the most vulnerable in society. Many having experienced extreme trauma in their childhood, these individuals place significant demands on cash-strapped services including the NHS, social services and local government. By placing them and their needs at the heart of the model, the Lead Worker Peer Mentor service unequivocally delivers positive sustainable change. It has relieved pressure from the emergency services while improving outcomes. Using the recognised Outcome Star measure, the 2018 Economic Impact Analysis indicated 52% of people report an increase in their Emotional and Mental Health scores.
It is the partnership between the Lead Worker and the Peer Mentor that makes the model so effective. The Lead Worker knows how to access services clients need, and the Peer Mentor, with their lived experience, quickly builds trust and is living proof change is possible. The ability of Peer Mentors to say to service users “I have been where you are” has a powerful impact and their status as a paid employee proves it is possible to develop a sense of self worth.
Their lived experience means Peer Mentors also understand the organisational policies, processes and procedures that make it difficult or impossible for service users to engage. They are, therefore, well placed to bridge the gap between services and the people who use them.
Compiled using the New Economy Manchester tool, the EIA compares the service use of individuals engaged with the Lead Worker Peer Mentor service over their final four quarters of engagement or the four quarters leading up to 31 March 2018, with the 12 months prior to their engagement.
The analysis shows engagement with the Lead Worker Peer Mentor service has resulted in:
Complementing these decreases is a marked increase in the engagement with services best placed to provide the support they need:
*The Fiscal benefit: savings to central and local government agencies, resulting in reduced overall government expenditure.
** According to the 2018 Economic Impact Analysis, available on request.
At the heart of the Changing Futures approach, the No Wrong Door Network is a group of organisations working together to ensure service users can access a whole system of support through one referral.
Our dedicated Lead Workers, skilled in helping people navigate the support services available, work alongside Peer Mentors with lived experience. This unique combination creates a tailored and empathetic approach, which bridges the gap between services and those who use them.
Often the best person to talk to is someone with similar experiences so our Experts by Experience take information on services directly to where the clients are, Crisis Point organisations where they may fall through the gaps, e.g. hostels.
We offer training to help our partners develop a PIE, which enables staff to develop reflection skills that help build collaborative, compassionate relationships with service users. Through these relationships service users are more able to achieve their goals.
Every Step of the Way is delivered by Birmingham MIND. It provides encouragement and enables Experts by Experience to get involved in a range of opportunities within the programme, which in turn contributes to systems change.
This post-programme workstream aims to prevent the “falling away” of support services once an individual is deemed well enough to ‘move on’.
The No Wrong Door Navigator Service provides hands-on support to service users, accompanying them to the right door, wherever they present. Standing by their side, the Navigators also support service users to attend their referral appointments and advocate on their behalf to ensure they are treated with dignity and respect.
By 31 March 2018, 284 service users engaged with the programme since 2015, 50 of whom have been on the programme for four quarters or more. Of these service users, only those with previous service use were included. Where one or two of the ongoing quarter’s data was missing, an average of the remaining two or three quarters was used to complete the data. The EIA was carried out using the national respected New Economy Manchester (http://www.neweconomymanchester.com).
The services users’ engagement with services prior to their engagement with the Peer Mentor Lead Worker service has been established through knowledge of their history and directly from the source, including police and NHS records
The Homeless Outcome Star comprises 10 categories: motivation and taking responsibility; self-care and living skills, managing money and personal administration; social networks and relationship; drug and alcohol use; physical health; emotional and mental health; meaningful use of time; managing tenancy and accommodation; offending.
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