Hard Edges
Today’s new report is both a helpful confirmation of some of what we know about people facing multiple and complex needs, and a fresh challenge to the conventional wisdom.
Over the last decade we’ve come leaps and bounds in articulating a case for better addressing people with multiple and complex needs. Indeed the discussion around ‘multiple needs’ or ‘multiple exclusions’ has now shifted from the margins to the mainstream. At Revolving Doors we see this as the work of a host of partners, the weight of real people’s stories and expertise, a growing evidence base and practitioner insight that has collectively started to ‘Turn the Tide’. A vision paper by Revolving Doors Agency and the MEAM coalition at the start of the coalition government made the political and moral case for effective co-ordinated services for this group, and in a sign of real progress the final year of the coalition is punctuated by a Treasury commitment to “look to develop and extend the principles of the Troubled Families programme to other groups of people with complex needs from the next Spending Review” (Autumn statement, pp.29 & 68).
Today’s report from Heriot Watt provides much needed additional ammunition. Through systemic trawling through various data sets, the authors have been able to provide concrete numbers that better define the scale and distribution of multiple and complex needs across England. They find that each year at least 58,000 people are experiencing a combination of homelessness, substance misuse and contact with the criminal justice system.
Understanding the prevalence of exclusion can help move towards solutions – some of which, as the report states, are yet to be imagined and will require significant collaborative leadership. As the report points out, one of the struggles is the silo nature of working at both national and local level. It is a tough time to invest in new, and perhaps initially costly, ways of working to generate improved outcomes and long term savings. This report shows that people in the ‘revolving doors’ group exist in all of our communities, and indicates that an ‘average’ Local Authority will have 1,470 people facing severe and multiple disadvantage over the course of a year. Clearly many Local Authorities know that many more of their citizens face such challenges. This fresh data can start to give local areas some justification for investment. And the findings confirm what many organisations working with people on the margins have long argued – that this group experience significant poverty, have in the majority of cases gone through significant childhood trauma and can often remain incredibly isolated, far too often experiencing boredom and loneliness.
As well as contextualising the debates around multiple and complex needs, the findings challenge some of the conventional wisdom. We now know that a majority of this group have children or have contact with children – they cannot be characterised simply as ‘single’. And we learn that many turn to families and friends in crisis. This was a key finding in Revolving Doors Agency’s research report ‘A Good Life’ (to be published) where people with direct experience of these issues were asked about what matters to them. In this research participants expressed the overwhelming importance of close relationships, although many also expressed complex feelings around those relationships – some also emphasising the feeling that they need to be self-reliant.
As we approach the 2015 election, there is an overwhelming case for fundamental service reform which starts from the experience, strengths and aspirations of service users themselves. Hard Edges helps sharpen that thinking and, along with the spending review commitment, should be the impetus for local areas to devise a strategy for multiple and complex needs.
