News Insight: Overhaul of family support saves millions

Chaotic families with multiple needs cost the public purse huge sums of money. So the incentive for councils to prevent family breakdown is higher than ever.

But while hard evidence to prove the benefits of preventative work has until now been thin on the ground, findings from intensive family support projects and collaborative initiatives such as Total Place are beginning to make the empirical case for early intervention.

Dave Hill, is now director of children's services in Essex, but held the post in Croydon until recently. He was instrumental in Croydon's Total Place pilot, which focused on improving early years services.

"The idea was that we mapped all of the money that we spent on children," he explains. "Not just social care and the NHS, but the benefits agencies, Jobcentre Plus, leisure, police and anybody else."

Organising services

The result was an eye opener, Hill admits. "We mapped it all out and put it on a wall," he says. "When we sat in front of it I nearly cried. There were thousands of services and thousands of people, and 50 different ways of accessing them."

The council and its partners worked out that they were spending nearly £206m a year on services for children from the moment of conception to age seven. But funding was structured around services, as opposed to families' needs.

"We did a piece of work about looking intensively with families at their experience and what their issues and problems are," Hill says. "We spoke face-to-face with a lot of families and children and we also got people to do video clips for us. Then we brought all of the public agencies together and got them to watch the experiences of people who had to struggle to access public services. It was the most humbling thing I have ever sat through. The families didn't feel they were getting a crack at solving their problems because of the way we were organising services."

After that, senior professionals from across public agencies in Croydon agreed to fundamentally redesign services around families.

"If there was one thing that struck me, it was the gap between services just after birth and when children go to nursery or reception class," Hill explains. "We just lose it and these are two or three of the most important years of children's lives. We spoke to midwives who were finding quite worrying signs of what was going on in the period just after birth and sometimes even before birth but felt unable to do very much."

To tackle this, Croydon's Total Place pilot aimed to remove professional barriers across children's services.

"A lot of the projects we've been developing have been about bringing in health visitors but not calling them health visitors, bringing in social workers but not calling them social workers, so that the family has access to a range of multi-disciplinary skills," Hill says.

Professionals also changed their approach to engaging families.

"We found that making people aware of services didn't actually get you very far," he explains. "Quite a lot of people knew the services were there but couldn't get to them. There were people that we needed to take to the services week after week. Some of the families we're talking about are notoriously good at avoiding intervention so we had to be tenacious."

The price of prevention

For Hill and his former colleagues in Croydon, Total Place helped focus efforts on early intervention by providing a realistic picture of how redesigning services can improve outcomes and save money.

Hill estimates the annual cost of one child in care to be about £52,000 but says the price of running one preventative project for a year works out at less than that. The potential Total Place cost savings are huge, Hill adds. By the time the borough's current cohort of four-year-olds turn 18 in 2024, Croydon should have saved more than £60m across public services.

BUILDING BRIDGES WITH VULNERABLE FAMILIES

Family Action's Building Bridges project supports parents with long-term mental health problems.

The initiative has been highlighted by the Centre for Excellence and Outcomes in Children's Services, which estimates the scheme saved the public purse £350,000 over the space of two years.

Helen Dent, chief executive of Family Action, says the families they work with are often at crisis point. "The Thompson family were referred to us because the children were on child protection plans and not attending school regularly," Dent says. "When we met the family, we discovered the mother had been discharged from hospital, her children had come home after five months in foster care, and they were reunited with no support. The mother was neither able to get her kids off to school nor to care for them adequately."

Effective intervention

To intervene effectively in this type of situation, Family Action has developed a system to work alongside parents, supporting them in the home during "pressure points" throughout the day.

In the Thompson household, the mother was asked when she needed help. "Until her drugs started working in the morning she couldn't do anything," Dent says. "So we'd turn up at 7am, have a cup of tea with her and then divide up the morning's tasks between us."

Most of the families involved in Building Bridges are in touch with nine to 12 agencies, so the scheme reduces duplication between services.

"We're rebuilding the parent's confidence and helping them in the areas where they don't feel they have enough skills," Dent explains.

Dent says the outcomes of families involved in Building Bridges are improved and help get children off child protection plans and avoid future mental health problems.

SPENDING AND SAVINGS IN CROYDON

£8.4m Croydon is anticipating savings of more than £8.4m between 2011 and 2014

£25m Savings anticipated between 2014 and 2017

£61m Total savings by 2023/24

In Croydon a total of £205.5m is spent each year on services from conception to age seven

£103m is payment directly to families from the Department for Work and Pensions and HM Revenue & Customs

£70.5m is Croydon Council spending

£32m is NHS Croydon spending

Source: Total Place Croydon